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RELEVANT study: Patient and physician perspectives on clinically-meaningful outcomes in advanced pancreatic ductal adenocarcinoma

Frizziero, Melissa
Mak, Soo Y
Nuttall, Christina
Lamarca, Angela
Yorke, Janelle
McNamara, Mairead G
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Abstract
Background Little is known about patient/physician views on treatment decision-making, goals and clinically-meaningful outcomes in advanced PDAC. Method A prospective questionnaire study in consecutive patients with newly-diagnosed advanced PDAC and their physicians. Patients completed a study survey and 2 QOL questionnaires (EORTC QLQ-C30 and PAN26) at 3 timepoints: before starting chemotherapy(T1); before(T2) and after 1st on-treatment scan (T3); paired survey was completed by physician at each timepoint. Results Of 71 patients, median age 65y, 52% male, 93% stage III-IV, 76% ECOG 0-1. 32% started triplet chemotherapy, 38% dual and 23% monotherapy. 12 physicians participated; 65 patientand 70 physician T1-surveys completed. Chemotherapy adverse event acceptability was similar between patients and physicians (infection: least acceptable, rash: most acceptable). For patients, the most important aspect when selecting chemo was OS; physicians favoured OS/side-effect balance. Thirty-six(55%) patients had life goals and priorities; only 11% physicians knew of these. Patients and physicians ranked ability to self-care as main priority, and ability to work as least important. Patients also prioritised spending time with family (ranked 1 out of 7); this was less important for physicians. Most patients(75%) were aware that treatment was unlikely to cure their cancer. Physician responses(85%) expected chemo to extend life by 1-2 months or 3-6m; 11% of patients expected it to be 3-6m, and 51% expected 1-5 or >5years. Similarly, 37% patients answered that minimal meaningful extra time was 1-5 or >5years, while 73% of physicians thought this was 3-6m. 42% of patients were willing to have chemotherapy even with large number of side-effects; only 10% of physicians thought they would. Physicians underestimated how many patients would be willing to accept chemo if it controlled symptoms but did not extend survival (47% vs 63% respectively). Updated results will be presented. Conclusion While patients had realistic expectations about cure, they largely overestimated the expected life extension.
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2020
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Meetings and Proceedings
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Pihlak R, Frizziero M, Mak S, Nuttall C, Lamarca A, Hubner R, et al. P-274 RELEVANT study: Patient and physician perspectives on clinically-meaningful outcomes in advanced pancreatic ductal adenocarcinoma. Annals of Oncology. 2020;31:S179.
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