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Relevant study: patient and clinician perspectives on clinically-meaningful outcomes in advanced pancreatic cancer
Frizziero, Melissa Mak, Soo Y Nuttall, Christina Lamarca, Angela Hubner, Richard A Valle, Juan W McNamara, Mairead G
Frizziero, Melissa
Mak, Soo Y
Nuttall, Christina
Lamarca, Angela
Hubner, Richard A
Valle, Juan W
McNamara, Mairead G
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Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis and significant symptom burden. This prospective observational study aimed to evaluate expectations and priorities of patients with advanced PDAC and their clinicians through a study survey and two quality of life (QoL) questionnaires (QLQ-C30 and PAN26) at three time-points: baseline (T1), before (T2) and after (T3) their 1st on-treatment CT scan. Over a 1-year period, 106 patients were approached, 71 patients and 12 clinicians were recruited. Choosing between treatment options, patients prioritised: 54% overall survival (OS), 26% balance between side-effects and OS, 15% could not choose and 5% favoured symptom control. These were significantly different from the clinician's answers (p < 0.001). Patients who prioritised OS had higher symptom burden (p = 0.03) and shorter OS compared to those who prioritised balance (p = 0.01). Most (86%) patients had personal goals they wanted to reach; clinicians knew of these in 12% of instances. Patient and clinicians' views regarding survival improvement from chemotherapy were significantly different: 81% of clinicians and 12% of patients thought 1-2 or 3-6 months extension, 58% of patients and 0% physicians thought 1-5 or >5 years (p < 0.001). At T1, patients had low QoL and worst symptoms were: 'Future worries', 'planning of activities', fatigue and pain. Patients were willing to accept significantly higher amounts of side-effects as a trade-off for extra time, than clinicians thought (p < 0.001). Overall, there are significant discrepancies between patient and clinicians' views about the aims, priorities and expected extension of life.
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Date
2023
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Pihlak R, Frizziero M, Mak SYG, Nuttall C, Lamarca A, Hubner RA, et al. Relevant Study: Patient and Clinician Perspectives on Clinically-Meaningful Outcomes in Advanced Pancreatic Cancer. Cancers (Basel). 2023 Jan 25;15(3). PubMed PMID: 36765698. Pubmed Central PMCID: PMC9913496. Epub 2023/02/12. eng.