Editorial Note: With advancements in breast cancer diagnosis and treatment, alongside the increasing diversity of patient needs, a comprehensive evaluation of treatment outcomes and improved quality of life have become focal points in this field. In recent years, Patient-Reported Outcomes (PROs) have emerged as a novel evaluation tool, playing an increasingly important role in breast cancer care. PROs go beyond traditional objective assessments like imaging and lab tests by emphasizing patients' subjective experiences, offering a new lens for both clinicians and patients to evaluate treatment effectiveness and quality of life. At the 2024 Breast Cancer Standardized Diagnosis and Quality Control Conference, Oncology Frontier interviewed Dr. Quchang Ouyang from Hunan Cancer Hospital to discuss the current applications, future trends, and significance of PROs in enhancing breast cancer diagnosis and treatment.

Oncology Frontier: Can you elaborate on the importance of Patient-Reported Outcomes (PROs) in breast cancer care? How do they help doctors and patients better assess treatment effectiveness and quality of life?

Dr. Quchang Ouyang: Patient-Reported Outcomes (PROs) focus on patients’ perceptions and subjective experiences, providing a broader assessment of treatment effectiveness beyond conventional imaging and lab-based evaluations. By utilizing PRO questionnaires, clinicians can determine whether treatments are improving patients’ quality of life and overall experience. This adds a critical dimension to understanding therapeutic outcomes and assessing the severity of the disease.

From a clinical practice perspective, PROs are invaluable in gauging patients’ satisfaction with treatments, whether in an inpatient or outpatient setting. Satisfaction, as measured by the alignment between patients’ expectations and actual outcomes, is a key metric for performance evaluations in tertiary public hospitals. PRO tools, therefore, help physicians better understand and manage patient satisfaction and actual outcomes throughout the treatment journey.

Oncology Frontier: As breast cancer treatments continue to evolve, the importance of drug development is growing. How does PRO contribute to clinical trials and drug development? In what ways does it help evaluate the efficacy and safety of new drugs?

Dr. Quchang Ouyang: Regulatory agencies, such as the FDA in the United States and the NMPA in China, increasingly emphasize a patient-centered approach in clinical research. This means clinical trials should not only rely on objective measures like imaging and lab results but also evaluate how interventions impact patients’ quality of life from their perspective.

PROs have become critical endpoints, either primary or secondary, in drug trials. For example, in studies on advanced breast cancer, traditional endpoints like progression-free survival (PFS) or overall survival (OS) are often accompanied by PROs as primary endpoints to assess improvements in quality of life. This shift underscores the pivotal role of PROs in evaluating new treatments, reflecting the growing focus on patient-centric clinical research.

Oncology Frontier: In your opinion, what areas of PRO evaluation in breast cancer still need improvement? How can clinicians better utilize PRO tools to enhance patient care?

Dr. Quchang Ouyang: PRO is more than just a measurement tool; it embodies a shift in healthcare philosophy from disease-centered to patient-centered care, prioritizing patients’ subjective experiences and responses to treatment interventions.

Currently, PRO tools for breast cancer in China are still in the early stages of development. With the guidance of institutions such as the National Cancer Center and the Breast Cancer Expert Committee of the National Cancer Quality Control Center, initiatives like the establishment of a China-specific PRO evaluation committee have begun to take shape. The development of the NCC-BC (China Breast Cancer PRO Scale) and tools like the CBCS-ESET, designed for early-stage breast cancer endocrine therapy, are significant milestones. However, given the relatively late start in this area, we must further promote the “patient-centered” philosophy and expand the adoption of these tools to better serve patients and address their quality of life.

Moreover, there is a pressing need to develop PRO tools tailored to China’s healthcare context and establish corresponding guidelines. These tools should accurately capture key indicators of quality of life for Chinese patients. Advancing this field will require sustained efforts to refine these instruments and promote their widespread use in clinical practice.

About Dr. Quchang Ouyang

• Director of the Breast Cancer Department at Hunan Cancer Hospital

• Chief Physician, Medical Doctor, and Master’s Supervisor

• Standing Member, Breast Cancer Expert Committee, Chinese Society of Clinical Oncology (CSCO)

• Member, Breast Cancer Committee, Chinese Anti-Cancer Association

• Standing Member, Breast Cancer Group, Chinese Medical Doctor Association’s Oncology Committee

• Member, National Expert Committee for Clinical Use of Anti-Tumor Drugs

• Member, Breast Cancer Expert Committee, National Cancer Quality Control Center

• Deputy Head, Breast Group, Chinese Research Hospital Association’s Precision Medicine and Oncology MDT Committee

• Chair, Oncology Professional Committee, Hunan Medical Association

• Chair, Breast Cancer Prevention and Treatment Professional Committee, Hunan Association for Maternal and Child Health and Family Planning

• Editorial Board Member, Journal of Clinical Oncology (Chinese Edition)

• Deputy Editor-in-Chief, Oncology Pharmacy