Oral Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Evaluating a digital psycho-oncology intervention (Finding My Way-Advanced) for women with metastatic breast cancer: Outcomes from a national multisite RCT. (126075)

Lisa Beatty 1 , Morgan Leske 1 , Emma Kemp 1 , Amy Rigg 1 , Robyn Combes 2 , Chantal Corthals 3 , Afaf Girgis 4 , Nicholas J Hulbert-Williams 5 , Richard Woodman 1 , Keelan Byrne 6 , Frances Boyle 7 , Katherine (Kate) Cox 8 , Anthony Daly 9 , Amanda Williams 10 , Belinda E Kiely 11 , Anna Rachelle Mislang 12 , Michelle Nottage 13 , Jessica Sharp 14 , Sina Vatandoust 12 , Desmond Yip 15 , Nicholas Zdenkowski 16 , The Finding My Way-Advanced Authorship Group 1 , Bogda Koczwara 1 4
  1. Flinders University, Adelaide, SA, Australia
  2. Flinders Centre for Innovation in Cancer, Adelaide, Australia
  3. Breast Cancer Network Australia, Camberwell, VIC
  4. University of NSW, Sydney, NSW
  5. Edge Hill University, Ormskirk, Lancashire, UK
  6. Peter MacCallum Cancer Centre, Melbourne, VIC
  7. University of Sydney, Sydney, SA
  8. Central Adelaide Local Health Network, Adelaide
  9. Cancer Council SA, Adelaide, SA, Australia
  10. Southern Adelaide Local Health Network, Adelaide, SA
  11. Campbelltown Hospital, Sydney, NSW
  12. Medical Oncology, Flinders Medical Centre, Adelaide, SA, Australia
  13. Royal Brisbane and Women's Hospital, Brisbane, QLD
  14. Swinburne University of Technology, Melbourne, VIC
  15. Australian National University, Canberra, ACT
  16. University of Newcastle, Newcastle, NSW

Objectives/purpose: While digital psycho-oncology interventions have proliferated, few target metastatic disease. Finding My Way – Advanced (FMW-A) is a co-designed 6-module self-guided online cognitive behaviour therapy-based program for women with metastatic breast cancer (MBC). This study evaluated program engagement and efficacy in improving quality of life (QOL) and distress.

Sample and Setting: An online national multisite randomised controlled trial (RCT) recruited eligible women with MBC (aged 18+ years, life expectancy of 6+ months, internet access, and sufficient English).  

Procedures: Participants were recruited via direct clinician approach (61.8%) across 10 sites in 5 states/territories, or self-referral (38.2%) from professional networks and social media. Participants were randomised to intervention (FMW-A) or control (Breast Cancer Network Australia’s ‘My Journey’ online). QOL was the primary outcome (EORTC QLQC30); secondary outcomes were general distress (DASS21), cancer-specific distress (PSS-SR), and fear of progression (FoPQ). Outcomes were assessed at baseline, post-intervention, and 3- and 6-month follow-up via self-report questionnaire.

Results: Of 511 eligible women, 280 (54.8%; 139 intervention, 141 control) consented. Participants, aged 27-89 years (Mean±SD=58.4±11.6), were diagnosed an average of 2.9±2.9 years prior (39% with de novo MBC), were predominantly married/partnered (59%), tertiary educated (76.8%), and not employed (58.5%). At baseline, participants exhibited significant burden: 48% and 55% exceeded clinical thresholds for impaired mental-QOL and physical-QOL respectively; many met clinical cut-offs for cancer-related distress (43.3%), fear of progression (51%), and depression, anxiety and/or stress (37.7%). Program engagement was moderate (Mean=3.03 modules accessed; 4.75 logins; 30/112 pages accessed). Follow-up is ongoing until September 2025 with efficacy data expected Q4/2025.

Conclusion and Clinical Implications: This is the first large-scale RCT of a digital psychosocial intervention for women with MBC. Despite experiencing heavy QOL and distress burden, participants showed only modest program engagement Clinical outcomes and implications for care will be discussed following the availability of efficacy data.