stakeholder perspectives on addressing adverse events from adjuvant cancer therapy a qualitative study background with increasing survival rates a growing population of patients with cancer have received or will receive adjuvant therapy to prevent cancer recurrences patients and caregivers will confront the complexities of balancing the preventative benefits of adjuvant therapy with possible nearterm or longterm adverse events aes adjuvant treatmentrelated aes from minimal to severe can impact therapeutic adherence quality of life emotional and physical health and survival however to the authors knowledge limited information is available regarding how stakeholders use or desire to use adjuvantrelated ae information to inform the care of patients with cancermethods a qualitative purposeful sampling approach was used to elicit stakeholder feedback via semistructured interviews 24 interviews drug development drug regulatory clinical payer and patientpatient advocacy stakeholders were questioned about the generation dissemination and use of adjuvant treatmentrelated ae information to inform the care of patients with cancer transcripts were coded independently by 2 senior health care researchers and reconciled to identify key themesresults all stakeholder groups in the current study identified needed improvements in each of the following 4 areas 1 improving the accessibility and relevance of aerelated information 2 better integrating and implementing available information regarding aes for decisions 3 connecting contemporary cultural and economic value systems to the generation and use of information regarding adjuvant treatmentrelated aes and 4 addressing a lack of alignment and ownership of stakeholder efforts to improve the use of ae information in the adjuvant settingconclusions despite commonalities in the overall needs identified by the diverse stakeholders in the current study broad systemic change has been stymied the current study identified the lack of alignment and the absence of a central owner of these diffuse efforts as a previously unrecognized hurdle to realizing the desired systemic improvements future initiatives aimed at improving quality of life and outcomes for patients receiving adjuvant therapy through the improved use of ae information must address this challenge through innovative collectives and novel leadership strategies