Community providers are growing more comfortable managing the varied adverse effect profiles of CDK4/6 inhibitors, shifting their primary concern toward patient access to care and transportation, according to Kimberly Podsada, BSN, RN, MSN, NP-C, a nurse practitioner at the University of California San Diego.
Speaking after moderating a Case-Based Roundtable on CDK4/6 inhibitors in patients with hormone receptor–positive metastatic breast cancer, Podsada said advanced practice providers in the community now better understand how specific agents present adverse effects—ranging from gastrointestinal symptoms to QTc prolongation and neutropenia—allowing teams to focus on logistics that affect treatment adherence.
Frequent upfront monitoring, including blood draws and EKGs, can be a significant burden for patients. Transportation challenges, lack of family support and the cost of rideshares or taxis were cited as common barriers, even for patients who live relatively close to their clinic.
Most clinics have adopted nurse navigator roles or similar staff to check on patients, coordinate follow-up lab appointments, and arrange home health services for blood draws when possible. Some centers offer travel assistance such as taxi vouchers, but those supports are often constrained by limited clinic funding.
Teams are also pursuing practical strategies to reduce patient burden, such as directing patients to closer labs and consolidating clinic visits and supportive services on the same day. Despite these efforts, the requirement for two-week interval blood work remains a persistent challenge for scheduling and access.
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