Oncologists’ perspectives on individualizing dose selection for patients with metastatic cancer

1531 Background: The goal of treatment for patients with metastatic cancer (MC) is to prolong and maintain quality of life. Patients and oncologists have questioned the current paradigm of initial dose selection for systemic therapy and want additional information about the potential trade-offs between efficacy and toxicity. However, empirical data on oncologists’ dose selection strategies and beliefs is lacking. Methods: ASCO conducted an international survey of medical oncologists who treat patients with metastatic breast or gastrointestinal cancers. Survey questions addressed experience with and attitudes towards reducing the standard dose of the first cycle of systemic therapy to minimize potential toxicity. The survey was open November 14 to December 13, 2021. Results: Among 3,099 eligible ASCO members, 367 completed the survey (response rate 12%), including 117 general oncologists (GO), 142 breast specialists (BRS), and 108 GI specialists (GIS). 77% of respondents practice in the US, 94% had experience leading a clinical trial, and 50% had been caregivers or patients themselves. Most respondents (52%) reported reducing the first dose of systemic agents at least 10% of the time in patients with MC to minimize toxicities. GIS were more likely to report reducing the first dose at least 10% of the time (72% vs. 50% of GO and 51% of BRS, p 50, p