Background Biological and precision therapies have the potential to transform prognosis of patients diagnosed with advanced cancer. Their availability has exploded in recent years. The experiences of patients on these medications are relatively unexplored, and it is unknown if supportive care needs of this patient group differ from those on ‘traditional’ chemotherapies. We aimed to explore and understand the experiences and supportive care needs of patients treated with these therapies.

Methods This analysis draws on the findings from Workstream 2 of the TARGET study: qualitative interviews with patients and healthcare professionals, to explore experiences of biological and precision therapies. Semi-structured interviews were conducted with patients with one of the following cancers; breast (female), lung, malignant melanoma, colorectal, renal, and ovarian, and healthcare professionals involved in the care of these cancers. Interviews were audio-recorded, and transcribed verbatim. A framework analysis was conducted, with the framework based on 11 previously identified domains of unmet needs.

Results Patients on biological and precision therapies are forced to deal with uncertainty surrounding treatment effectiveness, what second/third line treatment options are available, and longer but unknown life expectancy. They describe wide-ranging treatment side-effects which can have a profound impact on day-to-day life and alter their routines (e.g extreme diarrhoea where patients become frighted to go out, or go to unknown places for fear of lack of adequate facilities). Other side-effects include skin sensitivity (with some patients unable to walk as the soles of their feet were impacted) and nausea (resulting in patients unable to enjoy normal day-to-day activities such as coffees, and meals out). Patients describe being willing to tolerate a significant burden of side-effects for fear of treatment being altered and the cancer progressing. The length of time on treatment means relatively minor side-effects are more pronounced, as they are long lasting.

Conclusion Cancer patients receiving biological and precision medicines have unmet needs that differ from traditional cytotoxic cancer treatment. The findings have been used to inform development of a new unmet supportive care needs questionnaire, specific to this cancer patient group.