Abstract PS1-09-23: Physicians’ Perception & Impact of Quality Improvement Intervention: AI-enabled HER2-low Metastatic Breast Cancer Patient Notification Program

Abstract Background: Trastuzumab deruxtecan (T-DXd) was initially approved (Aug 2022) for treatment (trt) of HER2-low (IHC 1+ or IHC 2+/ISH-) unresectable or metastatic breast cancer (mBC) who have received a prior chemotherapy (CT) in the mBC setting. At approval, physicians in the US faced barriers in identifying patients (pts) with HER2-low for appropriate management. Florida Cancer Specialists & Research Institute (FCS) implemented a quality initiative (QI) wherein a random sample of 365 pts with HER2-low mBC were identified from the EMR using artificial intelligence (AI), and on 10/24/2022, physicians received an email alert identifying pts with HER2-low and mentioning the newly approved T-DXd. A retrospective study was conducted to evaluate the impact of the AI-enabled HER2-low notification program. Methods: The FCS EMR data were utilized to identify - Cohort 1 (pts with HER2-low mBC receiving CT on 10/24/2021 who initiated next line from 10/25/2021‒10/23/2022) and Cohort 2 (receiving CT on 10/24/2022 and initiated next line from 10/25/2022‒10/23/2023). Trt patterns were assessed descriptively, and real-world progression free survival (rwPFS) was assessed using Kaplan-Meier curves for both cohorts. A sensitivity analysis was performed to assess immediate changes in trt utilization following intervention by calculating monthly T-DXd use per eligible pts. A survey was emailed to FCS physicians to evaluate their familiarity with HER2-low trt guidelines and their perceived value of such QI. Results: 77 and 69 pts in Cohorts 1 (median age: 63 yrs) and 2 (61 yrs), respectively, were included. Within 1 year, a significant increase in T-DXd utilization (p<.05) and decrease in chemotherapy use were observed between cohorts; T-DXd rates were slightly higher among pts in the notification program (Table). In sensitivity analysis, 1in 4 eligible pts utilized T-DXd in the intervention month/Oct 2022 whereas 3 in 7 utilized T-DXd in the following month/Nov 2022. There was a trend for improvement in population-level rwPFS from Cohort 1 to 2 (Table). All surveyed physicians (n=20) were very (35%) or somewhat familiar (65%) with current clinical guidelines for treating HER2-low mBC. A majority reported these types of notification programs as “very helpful” (65%) but recommended embedding such alerts into pt charts (vs emails) and tailoring to specifically target trt-eligible pts. Conclusions: QI such as AI-enabled notification program can increase awareness of trt guidelines and new indications. Real-world data metrics to assess impact of QI must be benchmarked for continuous enhancements of interventions design, maximize pt outreach, and ultimately improve pt-level health outcomes. No causal association can be inferred between trt patterns and intervention due to limited pre-intervention period and expected natural uptake of a new trt post-approval. Citation Format: S. Mehta, A. Meo, A. Warner, A. Hernandez, A. Alajrash, P. Kothiya, L. Gordan, M. Hussein. Physicians’ Perception & Impact of Quality Improvement Intervention: AI-enabled HER2-low Metastatic Breast Cancer Patient Notification Program [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-09-23.