ASKHER2 breast cancer survey: key insights for clinicians

The ASKHER2 European Survey provided important insights into how perceived risk and fear of disease recurrence influence both health behaviors and decision-making in women with early-stage HER2+ breast cancer.  

In this interview, Nuria Perez Cullell (Director of Medical Affairs, Patient and Consumer Relations at Pierre Fabre Laboratories) explains what the ASKHER2 study set out to achieve, its key findings and how the results can help clinicians better communicate with their patients and engage them in shared treatment decision making.   

What is the ASKHER2 survey and what did it set out to achieve?  

Thank you very much for inviting Pierre Fabre Laboratories to this interview. I think it’s very important to have this opportunity to explain how we ensure that patient needs are correctly understood and are taken into account by doctors and other HCPs.

ASKHER2 is a European, multinational survey that aims to understand the perceptions and concerns of women with early HER2+ breast cancer. It was designed to understand three things. First, patients’ perceived risk and fear of breast cancer recurrence. Second, their willingness to undertake additional interventions to reduce the risk of recurrence. Third, how involved women wish to be in decision-making with their doctor.

Why was this important in informing the treatment journey and behavior of women with HER2+ early breast cancer?

We need to be aware that approximately 1 in 5 women with HER2+ breast cancer don’t know their individual risk of recurrence. This uncertainty can influence decision-making around treatment and care, which can subsequently impact patient outcomes. To ensure patients receive optimal information and care, HCPs and clinicians must have a clear understanding of their patients’ needs.

By understanding their patients’ needs clinicians can discuss and share appropriate treatment and care plans that better meet patient expectations. They can also involve their patients in the decision-making process to ensure that treatment plans address, as much as possible, concerns around disease recurrence and improve patient adherence to care programs.

The ASKHER2 survey, therefore, was designed to identify these needs and equip clinicians with the knowledge of how women with HER2+ breast cancer perceive their disease and to better understand their expectations. This is why it was very important to conduct this kind of survey.

How was the ASKHER2 survey designed to capture the real-world experiences of women diagnosed with HER2+ breast cancer?

ASKHER2 was designed as a cross-sectional, multinational, non-interventional, direct-to-patient survey that was conducted in six countries: France, Germany, Italy, Portugal, Spain and Sweden. By taking this approach and working with patient advocacy groups and patient panels, we succeeded in gaining insights from 622 women with HER2+ breast cancer.

Before launching the survey, qualitative cognitive interviews were carried out to test the quality of the questionnaire and make sure appropriate terminology was being used, so that patients could understand the questions. The questionnaire was then submitted to the Cerner Enviza/Oracle Life Science International Review Board. When it was accepted, the survey was launched.

Following the European ASKHER2 study, Pierre Fabre Laboratories decided to conduct a similar survey in China. The survey was adjusted and adapted to reflect Chinese culture and reflect the differences between Europe and China. It has recently been rolled out, and at the time of writing, 240 patients have been involved. We are aiming to conclude this survey at the end of 2025 and to disclose the results in mid-2026.

From the results of the European survey, what are the key takeaways that clinicians should be aware of?

A wealth of interesting information has been found through this survey. First, there’s the fact that women with HER2+ breast cancer rank the risk of disease recurrence as their number one concern. In addition, 20% of them report not discussing the risk of recurrence with their clinicians, which highlights a disconnection or misunderstanding between doctors and patients.

The second is that 97%, almost all participants, expressed a desire to be actively involved in healthcare decisions. Within this group, 49% wanted to be fully involved and 48% wished to be partially involved.

The survey also reported that women with early-stage HER2+ breast cancer are willing to make some changes to their lifestyle to decrease recurrence risk. For example, 77% of them were willing to modify their dietary habits, three-quarters of participants stated they were willing to exercise more frequently, whilst two-thirds (65%) were open to taking alternative treatments to better manage their disease and support their long-term health.

The survey also highlighted that the way clinicians communicate recurrence risk can influence how the patient perceives their disease. It is therefore crucial to focus on clinician communication approaches, which can support patients in taking actions to decrease their recurrence risk, increase patient involvement and treatment adherence. This is very important and is a matter of training and finding patient-friendly ways to present clinical information.

Last but not least, 72% of the women stated they want information presented in plain language to be sure they understand what clinicians are telling them. Globally, patients want short and simple explanations. They want science expressed in a clear way to help them make the right decision, which in turn aids treatment adherence.

How do you think these results should impact care for women with HER2+ early breast cancer moving forward? 

Our objective is to use the results of the ASKHER2 study, to first inform clinicians and then to work with them to see how we can present this information to patients in the best way. This should prevent further misunderstandings and pave the way for more shared decision-making when it comes to treatment choices.

We are convinced that if we help physicians better communicate with their patients, they can provide their patients with better knowledge and ensure less uncertainty. With shared decision-making, we can increase adherence to their care programs, resulting in better health outcomes.

How can clinicians be supported to better convey complex information like recurrence risk?

I believe that clear, balanced and open communication with patients is key. If we try to imagine what could be done to achieve this, communication training for physicians must be a focus. Clinicians perfectly know the pathology but helping them develop their patient communication skills is something that could help everybody. Second is to advise clinicians to increase the use of short explanations using plain language to help patients easily understand complex clinical information. Third is to increase the coordination between multidisciplinary teams, as its not only the clinician and patient, but many teams working around them, and improving coordination could help all involved to be better aligned around the decision-making process.

Listening better to the patient, learning to talk to them, developing tools with plain language and strengthening the links between all healthcare professionals will help change the way patients are cared for, moving from a “focus on the pathology” to a “focus on the patient”.

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The opinions expressed in this article are those of the author and do not necessarily reflect the views of Oncology Central or Taylor & Francis Group.

This interview was sponsored by Pierre Fabre Laboratories.