Global Variations in Oncology Professionals' Confidence Levels for Managing Antibody-Drug Conjugate Toxicities: A Cross-Continental Survey

Background: Antibody-drug conjugates (ADCs) represent a promising therapeutic approach in oncology, but managing their toxicities remains challenging. This survey aimed to assess confidence levels in ADC toxicity management among oncology professionals globally. Methods: A cross-sectional survey was conducted using the ONCOassist mobile, a CE-marked oncology application widely used by oncologists globally as support in clinical practice. Confidence in toxicity management was measured on a five-point scale. Predictor variables included income level, professional role, specialization, and cancer type treated. Results: The survey was offered to 5,883 users and responses were received from 1,256 oncology healthcare professionals (HCPs) across various continents and professional roles. Medical oncologists represented the largest group (46%). Most of the HCPs were from high or upper-middle income countries (75%) with most nurses (86%) from high income countries. Respondents from Europe and North America reported higher confidence ratings, while those from Asia, Africa, and Oceania tended to report lower confidence levels (p < 0.001). Respondents from lower-middle-income countries reported lower confidence compared with those from high and upper-middle-income countries (p < 0.001). Additionally, senior physicians exhibited substantially higher confidence compared to junior physicians and nurse practitioners (p < 0.001, for both). Specialty affected confidence levels, particularly in surgical oncologists who reported the lowest confidence (p < 0.001). Conclusion: This global survey reveals significant disparities in confidence levels for managing ADC toxicities across regions, professional roles, and specializations. These findings may suggest the need for targeted educational interventions and support systems to enhance competences in managing ADC-related toxicities, ultimately improving the global standard of care for patients receiving ADCs.