Relevant study: patient and clinician perspectives on clinically-meaningful outcomes in advanced pancreatic cancer
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Authors
Pihlak, RilleFrizziero, Melissa
Mak, Soo Y
Nuttall, Christina
Lamarca, Angela
Hubner, Richard A
Valle, Juan W
McNamara, Mairead G
Affiliation
Division of Cancer Sciences, University of Manchester, Manchester M20 4BX, UKIssue Date
2023
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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.Citation
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.Journal
CancersDOI
10.3390/cancers15030738PubMed ID
36765698Additional Links
https://dx.doi.org/10.3390/cancers15030738Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.3390/cancers15030738
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