Prehabilitation and Supportive Care in Oncology Treatment for women with Breast Cancer (PROactive-B) receiving neoadjuvant chemotherapy: program development and feasibility

Background: Women treated for breast cancer typically experience an intensive treatment phase including surgery, systemic therapy and radiation therapy. The increased use of neoadjuvant therapy in early stage, but high-risk breast cancer, provides an opportunity to develop a prehabilitation program to build self-efficacy, keep women physically and psychologically well through treatment and prepare women for surgery and any adjuvant treatment/s. Methods: We undertook a co-design approach to developing a program, conducting a qualitative study to explore consumers' and healthcare professionals' views about the content and format of the proposed prehabilitation intervention. The PROactive B program was developed and a feasibility, mixed-method study is underway. Results: Codesign: Eleven women with breast cancer and 11 healthcare professionals participated in focus groups and interviews. Key themes for consumers included: the need for a single point of contact (navigation), preference for a "package", being organised, and individualised along with engagement of the oncologist. Additional features highlighted strong support from healthcare professionals, wanting to be on the front foot (proactive), belief in the benefit of exercise for treatment tolerability and minimising side effects and providing support. Pilot study: 23 participants were recruited over a 10-month period. Of those 23, there were two withdrawals; 11 completions of the intervention; 10 still participating in the intervention. There were no dropouts to date. Exit interviews were completed with five participants. Interim analysis will be presented at the conference. Conclusions: The integration of personalised exercise and supportive care programs in women with breast cancer receiving neoadjuvant therapy is an important component of holistic cancer care. Results of the PROactive B study will not only provide insight into the appropriateness and acceptability of a multi-modal prehabilitation program for women receiving neoadjuvant therapy for breast cancer, but also provide an understanding of the implementation framework which may facilitate such a program.