Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Does adding therapist guidance to Finding My Way-Advanced improve engagement and outcomes in women with metastatic breast cancer? A feasibility pilot. (146064)

Amy Rigg 1 , Emma Kemp 1 , Bogda Koczwara 1 2 , Joanne Shaw 3 , Morgan Leske 1 , Nicholas Zdenkowski 4 5 6 , Frances Boyle 3 7 , Anna Rachelle Mislang 8 , Sina Vatandoust 8 , Emma Zaina 1 , Nicola Freeman 1 , Alma Dayawon 9 , Chantal Van Der Linden 9 , Lisa Beatty 1
  1. Flinders University, Adelaide, South Australia, Australia
  2. University of New South Wales, Sydney, New South Wales, Australia
  3. The University of Sydney, Sydney, New South Wales, Australia
  4. University of Newcastle, Newcastle, New South Wales, Australia
  5. Maitland Private Hospital, Maitland, New South Wales, Australia
  6. Lake Macquarie Private Hospital, Sydney, New South Wales, Australia
  7. Mater Hospital, Sydney, New South Wales, Australia
  8. Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
  9. Consumer Representative, Breast Cancer Network Australia, Melbourne, Victoria, Australia

Aims: To evaluate the engagement and clinical outcomes of adding guidance to Finding My Way-Advanced (FMW-A), an online psychosocial intervention for women with metastatic breast cancer (MBC), and compare outcomes across email-, telephone-, and videoconference-guided delivery.

Methods: A multisite feasibility pilot RCT recruited women aged ≥18 years with MBC, sufficient English, internet access, and >6-month life expectancy. All participants accessed the FMW-A program and were randomly allocated to clinician-guidance via email, telephone or , receiving a minimum of 2 sessions over six weeks. Feasibility (uptake, attrition, adherence, acceptability and fidelity) was the primary outcome. Website analytics assessed engagement. Quality-of-life, general distress, cancer-specific-distress, and fear-of-progression were assessed at baseline, post-intervention and 3-month follow-up. Outcomes were compared with the historical self-guided FMW-A trial, and across guidance modalities.

Results: 64 participants enrolled (21 email, 21 telephone, 22 videoconference) between July—November 2025 (Mean=12.8 enrolled/month). The recruitment target (60) was exceeded (66% uptake; 97 approached), with low attrition (8%). Participants accessed more modules than in the historical self-guided trial (Mean=3.2±2.2 vs Mean=2.5±2.0). Telephone-guidance demonstrated the highest engagement (email: Mean=3.4±2.3, Median=2.5; telephone: Mean=3.6±1.8, Median=4; videoconference: Mean=2.5±2.1, Median=2) and retention across guidance sessions (session uptake:17—86%; email:10—90%; telephone:33—90%; videoconference:9—77%). Compared with the self-guided cohort, clinician-guided participants demonstrated greater improvements in general distress and global quality-of-life. However, clinician guidance did not demonstrate consistent advantages across clinical outcomes; fear-of-progression did not differ between-groups, while several quality-of-life functioning domains and cancer-specific distress favoured the self-guided cohort. Few differences emerged between guidance modalities.

Conclusions: Adding guidance to FMW-A was feasible and increased program engagement. Despite improvements in general distress and global quality-of-life relative to the self-guided cohort, clinical benefits were not consistently observed across outcomes. Across modalities, guidance influenced engagement but produced comparable psychosocial , highlighting the need to identify when and how guidance provides the greatest benefit.