Eur J Cancer Care 2016; 1–9 wileyonlinelibrary.com/journal/ecc | 1 © 2016 John Wiley & Sons Ltd Accepted: 5 November 2016 DOI: 10.1111/ecc.12624 ORIGINAL ARTICLE New oral targeted therapies for metastatc breast cancer disrupt the traditonal patents’ management—A healthcare providers’ view E. Martn PhD Student in Public Health 1,2 | L. Pourtau PhD, Sociologist 1,2 | M. Di Palma MD, Medical Oncologist 3 | S. Delaloge MD, Medical Oncologist 4 1 Université Paris-Sud/Paris Saclay, Le Kremlin-Bicêtre, France 2 Laboratoire EA 1610, Faculté des sciences d’Orsay, Orsay, France 3 Département Ambulatoire, Gustave Roussy, Villejuif, France 4 Département de Médecine Oncologique, Gustave Roussy, Villejuif, France Correspondence Elise Martn, Gustave Roussy, 114 Rue Edouard Vaillant, Espace Maurice Tubiana (-1), Villejuif F-94805, France. Emails: mlle.martn.elise@gmail.com; el.martn@gustaveroussy.fr Although a cure stll cannot be expected for metastatc breast cancer, thanks to pro- gressive advances in treatments, life expectancy has been increasing over the past 15 years. This study aims to present the impact on the organisaton of patents’ man- agement of newly released oral targeted therapies dedicated to metastatc breast can- cer and the obstacles to their difusion. Our work is based on the analysis of 40 semi-structured interviews, conducted with oncology healthcare professionals in three regions of France (2015–2016). It shows three main results. First, the prescrip- ton of an oral targeted therapy requires greater collaboraton between healthcare professionals than traditonal intravenous oncology drugs, which may be challenging. Second, there remain many barriers to the disseminaton of oral targeted therapies. Third, taking an oral targeted therapy keeps the patent away from the hospital facility and asks for a strong therapeutc alliance. The management of oral targeted therapies is tme-consuming for medical oncologists and disrupts the traditonal care pathway. The multplicaton of actors involved in patents’ management reinforces the slow- down in the deployment and acceptance of therapeutc innovatons. More players equal a higher risk of slowdown. Questoning and re-designing hospital organisaton and management modalites towards this type of care are critcal. KEYWORDS care pathways, everolimus, France, metastatc breast cancer, oral targeted therapy, patent management, semi-structured interviews 1 | INTRODUCTION Breast cancer is the most common cancer among women, the most frequent cause of cancer death in women in less developed regions, and the second cause of cancer death in more developed regions (Globocan, 2012). It thus represents a major public health issue today (Xiaomei & Herbert, 2006). Nevertheless, its relatve mor- tality has decreased signifcantly in recent years due to increased awareness, early screening and major therapeutc advances (American Cancer Society, 2005). Although 70%–80% of breast cancer patents should heal, much is lef to be done in the remaining 20%–30% who relapse and ultmately die of their disease (Sánchez- Muñoz, Pérez-Ruiz, Ribelles, Marquez, & Alba, 2008). The types of molecules developed to treat cancer, including stage 4 breast cancer, have evolved a lot with the expansion of targeted ther- apies (Perez & Spano, 2012; Sánchez-Muñoz et al., 2009) and biother- apies since the 2000s. The so-called “precision medicine” allows the study of genetc alteratons and biomarkers present in the genome of tumours, making it possible to determine more accurately its charac- teristcs so as to target potental treatments (Cho, Jeon, & Kim, 2012; Onest, Vicier, & André, 2015). The diagnosis and prognosis of patents could thus be made in an individualised way, depending on the genetc