Patient experience with later line chemotherapy in four tumor types.

e24142 Background: Understanding patient experiences with prior therapies offers crucial context for assessing the quality of life benefits of antibody-drug conjugates (ADCs). This study aimed to qualitatively explore the perspectives of patients with advanced or metastatic endometrial cancer (EC), cervical cancer (CC), gastric cancer (GC), and epidermal growth factor receptor mutation (EGFRm) positive non-small cell lung cancer (NSCLC) who had progressed to second-line (2L) and later therapies, focusing on tolerability challenges and quality of life (QoL) impacts related to past and current treatments. Methods: This study employs qualitative data to capture treatment burden and impact from the patient perspective, emphasizing the value of patients’ own words and experiences. In-depth, semi-structured interviews were conducted with 25 patients (EC=8, CC=5, GC=5, NSCLC=7). Interviews explored patients’ experiences with treatment tolerability issues, impact on daily life, coping strategies, and motivations to continue their treatment. Data were analyzed using a modified content analysis framework to identify key concepts. Results: Most patients anticipated treatment-related side effects and proactively discussed these with their healthcare providers. Across tumor types, the most burdensome symptoms included gastrointestinal issues (nausea, diarrhea) and neurological effects (notably neuropathy and brain fog), resulting in significant, multi-domain QoL impacts. Commonly reported effects in the physical domain included persistent fatigue (particularly among NSCLC patients), reduced mobility due to neuropathy, and appetite loss from nausea. Emotional distress was prevalent, characterized by sadness, grief, and self-consciousness stemming from visible treatment effects (e.g., hair loss, IV marks). Reduction in social participation and feelings of isolation were also reported, such as staying home from important events or feeling the need to keep cancer-related struggles private. Many patients described disruptions to work and daily routines, with some troubled by job modifications or cessation. Despite these challenges, patients remained motivated to continue treatment by the desire to prolong survival and maintain connections with loved ones. Conclusions: This real-world, qualitative analysis highlights the extensive physical, emotional, and social impacts of 2L+ therapies on patients with advanced cancers. These insights are critical for informing ADC treatment integration as a patient-centered treatment option and facilitating scientific discourse to better address patient QoL needs.