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dc.contributor.authorPihlak, Rille
dc.contributor.authorFrizziero, Melissa
dc.contributor.authorMak, Soo K
dc.contributor.authorNuttall, Christina
dc.contributor.authorLamarca, Angela
dc.contributor.authorHubner, Richard A
dc.contributor.authorYorke, Janelle
dc.contributor.authorValle, Juan W
dc.contributor.authorMcNamara, Mairead G
dc.date.accessioned2021-03-08T06:18:35Z
dc.date.available2021-03-08T06:18:35Z
dc.date.issued2020en
dc.identifier.citationPihlak R, Frizziero M, Mak SK, Nuttall C, Lamarca A, Hubner RA, et al. RELEVANT study: Patient (Pt) and physician ( PI) perspectives on meaningful outcomes in advanced pancreatic ductal adenocarcinoma (PDAC). Journal of Clinical Oncology. 2020;38(29).en
dc.identifier.urihttp://hdl.handle.net/10541/623755
dc.description.abstractBackground: PDAC is an aggressive cancer with median overall survival (OS) ~6 months (m). Methods: Pts with advanced PDAC due to start first-line chemo (Chx) completed 1 study survey and 2 quality of life (QoL) questionnaires (QLQ-C30 and PAN26) on 3 time-points: baseline (T1), before (T2) and after (T3) their 1st on-treatment CT scan, PIs filled in paired surveys T1/2/3. Results: 71 Pts and 12 PIs were recruited. 4% Pts died/deteriorated between consent and T1, 28% between T1 - T2 (~2.3m later), 13% between T2 - T3 (~1.3m), only 55% reached T3. 49% Pts preferred to share decision making with their PI, 31% Pts preferred to make the final decision about treatment after considering PI opinion. 86% Pts had personal goals to reach (12% PIs knew of these). 70% Pts were aware that Chx was unlikely to cure cancer however, they had much higher expectations than PIs (%, Table). Choosing between treatment options Pts prioritised: 54% OS, 26% balance between side-effects (SEs) and OS, 15% could not choose and 5% symptom control. These did not match with PIs (p<0.001). Pts who prioritised OS had higher symptom burden (p=0.03). OS was different in these Pts: who prioritised symptom control- OS 2.8m from T1, OS priority- 6.4m, could not choose- 8.7m and balance priority- 9.2m (p=0.01). At T1 Pts had low QoL (57/100, higher better). ‘Future worries’ and ‘planning of activities’ were scored the worst (58 and 56/100, lower better). Clinically significant (+/- 10p) worsening between T1/2/3 were: PF (10p), nausea/vomiting (NV, 12p), body image (18p p=0.01), taste (25p p=0.002). Financially 29% Pts were “a little/ lot” out of pocket at T1, 41% at T2 (p=0.036), 42% at T3 (p=0.034). Acceptability of SEs showed that least acceptable SEs (ranked 1-10, 10-least) were the ones Pts were already struggling with: NV (ranked 9/10, 46p/100 on QLQ), diarrhoea (8/10, 45/100); fatigue (less acceptable T3 (p=0.05), 46/100); appetite loss (7-8/10, 47/100). In contrast, most Pts (97%) were willing to take few/medium and around 50% large amount of SEs as a trade-off for extra time, whilst 9% PIs thought that Pts would accept excess SEs (p<0.001). Conclusions: Pts worry about future, have high symptom burden and high expectations of Chx. Pts want to be involved in decisions, but the contrasting views between Pts and PI show differing aims.en
dc.language.isoenen
dc.titleRELEVANT study: Patient (Pt) and physician ( PI) perspectives on meaningful outcomes in advanced pancreatic ductal adenocarcinoma (PDAC)en
dc.typeMeetings and Proceedingsen
dc.contributor.departmentThe University of Manchester/The Christie NHS Foundation Trust, Manchesteren
dc.identifier.journalJournal of Clinical Oncologyen
dc.description.noteen]


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