291P Perceptions of antibody drug conjugate (ADC)-induced nausea and vomiting: Results of a survey of healthcare providers at ESMO

The breast cancer (BC) treatment landscape is evolving with the availability of new anticancer agents such as antibody drug conjugates (ADCs). Based on major antiemetic guidelines, patients (pts) receiving trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG) are considered at high risk of experiencing nausea and vomiting (N&V) and should routinely be given proper antiemetic prophylaxis. A recent survey was conducted with healthcare providers (HCPs) attending the ESMO 2023 Congress to assess their experience with and perceptions of ADCs, including the emetogenicity and their approach to antiemetic prophylaxis. At ESMO 2023, HCPs were recruited to complete a short web-based survey. Target participants were those caring for oncology pts with solid tumors and who were at least familiar with ADC treatments. "In target" participants completed the survey on a computer in the exhibit hall. A total of 443 HCPs were recruited, with 333 deemed eligible (311 oncologists and 22 other HCPs). The majority of participants treated pts with BC (71%), followed by lung cancer (56%); 61% (n = 202) of all HCPs had or were using ADCs in practice (most commonly T-DXd and SG in BC). 66% and 68% of HCPs using T-DXd and SG, respectively, considered them to be highly or moderately emetogenic; however, 32% and 23% of HCPs considered them to be minimally emetogenic in the BC subset. Perception of emetogenicity was lower among non-users than users. N&V were commonly reported as ADC side effects by current/past users of ADCs; 63% of HCPs reported having had pts with N&V at least sometimes in the acute phase (0-24h post-treatment), 64% in the delayed phase (>24-120h) and 42% in the extended delayed phase (days 5-7); 27% of HCPs reported N&V occurring often/always in both the acute and delayed phases. Of the pts treated with ADCs, a 5-HT3 receptor antagonist (RA) + dexamethasone with or without an NK1 RA was the most common antiemetic prophylaxis; however, importantly, 37% of pts did not receive prophylaxis. This survey highlights a gap between scientific data and HCP's perceptions and emphasizes the need for adequate studies and implementation of guidelines on the optimal use of antiemetic prophylaxis.