CHALLENGE
In HR+/HER2- advanced breast cancer, following progression on endocrine therapy plus CDK4/6 inhibitors, the growing range of therapeutic options makes the choice of next-line strategy increasingly complex. There is no shared framework defining the weight of different clinical drivers in the decision-making process.
APPROACH
A prospective observational study based on 100 simulated clinical cases, built from variables prioritised by an expert board. Around 30 oncologists evaluated the scenarios through a structured survey, generating approximately 3,000 therapeutic decisions.
OUTPUT
A structured dataset of therapeutic decisions, analysis of the main prescribing patterns and variables associated with treatment choice, a closing results discussion meeting with the faculty, and an executive report.
OUTCOME
The main drivers of therapeutic decisions were identified — and, crucially, the scenarios characterised by the greatest disagreement among specialists, translating clinical variability into quantitative data that pinpoints areas of persistent decision-making uncertainty.