Addressing disparities and challenges in underserved patient populations with metastatic breast cancer in Europe.

People with metastatic breast cancer face many challenges and disparities in obtaining optimal cancer care. These challenges are accentuated in underserved patient populations across Europe, who are less likely to receive quality healthcare for reasons including socioeconomic inequalities, educational or cultural status, or geographic location. While there are many local and national initiatives targeted to address these challenges, there remains a need to reduce disparities and improve access to healthcare to improve outcomes, with a focus on multidisciplinary stakeholder engagement. In October 2019, a range of experts in metastatic breast cancer, including healthcare professionals, patient representatives, policymakers and politicians, met to discuss and prioritize the critical needs of underserved patient populations with metastatic breast cancer in Europe. Six key challenges faced by these communities were identified: the need for amplification of the metastatic breast cancer patient voice, better and wider implementation of high-quality guidelines for metastatic breast cancer, more collaboration between stakeholders, tailored support for patients from different cultural and ethnic backgrounds, improved data sharing, and work-related issues. The Expert Panel then conceived and discussed potential actionable goals to address each key challenge. Their conclusions present a set of interrelated approaches to address the different challenges and could serve as the basis for concerted improvement of the lives of patients with metastatic breast cancer in Europe.
Competing Interests: Declaration of competing interest Emilio Alba: None. Concepción Biurrún: None. Fatima Cardoso:. Consultancy role for Amgen, Astellas/Medivation, AstraZeneca, Celgene, Daiichi-Sankyo, Eisai, GE Oncology, Genentech, GlaxoSmithKline, Macrogenics, Medscape, Merck-Sharp, Merus BV, Mylan, Mundipharma, Novartis, Pfizer, Pierre-Fabre, prIME Oncology, Roche, Sanofi, Samsung Bioepis, Seattle Genetics, Teva. PierFranco Conte: Speaker (Novartis, Roche, AstraZeneca); Travel grant (Novartis, Celgene, Tesaro); Institutional research grant (Novartis, Merck KGa, Roche, Bristol Myers Squibb) Rosanna D’Antona: None. Jacques De Grève: None. Joseph Gligorov: None. Françoise Meunier: None. Carlo Palmieri: Advisory boards and funding for clinical studies (Pfizer). Oriol Sola-Morales: Dr. Sola-Morales has consulted for most of the multinational pharmaceutical companies, including all ‘top 10’. He has received fees and honoraria for such consultancies and is currently engaged in several projects with many of these companies. He holds ownership of several start-up companies in the healthcare field and has had in the past stock ownership of ‘Top 10’ pharmaceutical companies. Luzia Travado: None. Catherine Ubaysi: Compensation for representing Patients en réseau at events. Roberta Ventura: None. Eduard Vrdoljak: Support for clinical trials and scientific projects (Pfizer, Roche, Bristol Myers Squibb, AstraZeneca); Speaker fees and consulting (Amgen, Astellas, AstraZeneca, Boehringer Ingelheim, Johnson & Johnson, Novartis, PharmaSwiss, Pfizer, Roche, Sanofi, MSD, Merck). Andrew Walker: Pharmaceutical & biotechnology companies (Abbvie, Akcea, Albireo, Alexion, Allergan, Astellas, AstraZeneca, Autolus, Avexis, Biocrysta, Bristol Myers Squibb, Calico, Celgene, Chiesi, Daiichi-Sankyo, Deciphera, Eli Lilly, Ferring, Galapagos, GSK, GW Pharma, Intercept, Ipsen, Janssen, Jazz, Kite/Gilead, Les Laboratories Servier, Lundbeck, Merck Serono, Mundibiopharma, Mylan, Norgine, Novartis, NovoNordisk, Pfizer, Pierre Fabre, RegenXBio, Takeda, UCB, Vertex). Consultancy companies (Adeptfield, Atheneum Partners, Bresmed, CB Partners, Charles Rivers Associates, Creativ Ceutical, Datamonitor, de Facto Research, Dolon, DRG, Evidera, Executive Insight, Fiecon, Fingerpost Consulting, Galbraith Wight, Guidehouse, Health Advances, HiTT, Huron Consulting Group, Inbeeo, Informa/Data Monitor, IQVIA, M2Econ, Market Access Transformation, Miller Economics, Mirador, Mtech Access, Navigant, Open Access, Pagoda S&L Int. Services, Parexel, Partners 4 Access, Plich Advisory Services, Precision Xtract, PRMA, PWC, QualWorld, Remap, Research Partnership, RJW Partners, SAI Med Partners, Simon Kucher, Therapeutic Challenges, Two Labs, Valid Insight, Verto, Wellmera, Windrose, ZS Associates). Public sector: University of Aberdeen. Theresa Wiseman: None. Lieve Wierinck: None. Rachel Wuerstlein: Agendia, Amgen, Aristo, AstraZeneca, Boehringer Ingelheim, Carl Zeiss, Celgene, Clinsol, Daiichi-Sankyo, Eisai, Genomic Health, GlaxoSmithKline, Hexal, Lilly, Medstrom Medical, MSD, Mundipharma, Nanostring, Novartis, Odonate, Onkowissen, Paxman, Palleos, Pfizer, Pierre Fabre, Puma Biotechnology, Riemser, Roche, Sandoz/Hexal, Seattle Genetics, Tesaro, Teva.
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