Judith Lacey1,2, Anna J Lomax3, Catriona McNeil3,4, Michael Marthick3, David Levy3,5, Steven Kao3,4, Theresa Nielsen3, Haryana M Dhillon5. 1. Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Rd, Camperdown, NSW, Australia. Judith.Lacey@lh.org.au. 2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Judith.Lacey@lh.org.au. 3. Chris O'Brien Lifehouse Comprehensive Cancer Centre, Missenden Rd, Camperdown, NSW, Australia. 4. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 5. Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, University of Sydney, Sydney, NSW, Australia.
Abstract
INTRODUCTION: Increasing numbers of metastatic melanoma (MM) patients are receiving immunotherapy treatment, including pembrolizumab, and the impact on their well-being is underexplored. OBJECTIVES: To assess the feasibility of a multimodal supportive care program to MM patients being treated with pembrolizumab. METHODS: This pre-post-test feasibility cohort study recruited MM participants treated with pembrolizumab: (i) supportive care intervention with usual care and (ii) usual care. The intervention comprised comprehensive medical assessment by supportive care physician (SCP), exercise physiologist (EP), and dietitian then a tailored supportive care program. Programs included exercise, dietary advice, non-invasive complementary therapies, and psychology consultation. Outcome measures included adherence, patient-reported symptoms, anxiety and depression, and toxicity. Descriptive data are reported. RESULTS: We recruited 28 participants: 13 intervention and 15 control; three did not complete the study. Most were male, with median age 66 (range 42-85) years. All intervention participants completed baseline assessments with SCP, EP, and dietitian. Two missed follow-up with EP or dietitian. Symptoms most troubling at baseline were as follows: fatigue (n = 6), sleep (n = 6), general aches and pains (n = 5), and memory (n = 4). All intervention participants were prescribed 16 exercise sessions; 8 (50%) completed all; overall exercise adherence was 85%. Integrative therapies were accessed by 85% (11) participants. Immunotherapy-related adverse event rates were low and SCP consultation identified symptoms not captured by CTCAE 4.0. CONCLUSIONS: A holistic supportive care intervention tailored to individual needs is feasible. The symptom burden in MM patients was low. Further investigation of the intervention is warranted, focused on populations with higher symptom burden to improve outcomes.
RCT Entities:
INTRODUCTION: Increasing numbers of metastatic melanoma (MM) patients are receiving immunotherapy treatment, including pembrolizumab, and the impact on their well-being is underexplored. OBJECTIVES: To assess the feasibility of a multimodal supportive care program to MMpatients being treated with pembrolizumab. METHODS: This pre-post-test feasibility cohort study recruited MMparticipants treated with pembrolizumab: (i) supportive care intervention with usual care and (ii) usual care. The intervention comprised comprehensive medical assessment by supportive care physician (SCP), exercise physiologist (EP), and dietitian then a tailored supportive care program. Programs included exercise, dietary advice, non-invasive complementary therapies, and psychology consultation. Outcome measures included adherence, patient-reported symptoms, anxiety and depression, and toxicity. Descriptive data are reported. RESULTS: We recruited 28 participants: 13 intervention and 15 control; three did not complete the study. Most were male, with median age 66 (range 42-85) years. All intervention participants completed baseline assessments with SCP, EP, and dietitian. Two missed follow-up with EP or dietitian. Symptoms most troubling at baseline were as follows: fatigue (n = 6), sleep (n = 6), general aches and pains (n = 5), and memory (n = 4). All intervention participants were prescribed 16 exercise sessions; 8 (50%) completed all; overall exercise adherence was 85%. Integrative therapies were accessed by 85% (11) participants. Immunotherapy-related adverse event rates were low and SCP consultation identified symptoms not captured by CTCAE 4.0. CONCLUSIONS: A holistic supportive care intervention tailored to individual needs is feasible. The symptom burden in MMpatients was low. Further investigation of the intervention is warranted, focused on populations with higher symptom burden to improve outcomes.
Entities:
Keywords:
Feasibility study; Immune checkpoint inhibitor; Immunotherapy; Metastatic melanoma; Oncology; Pilot study; Supportive care
Authors: Jacob Schachter; Antoni Ribas; Georgina V Long; Ana Arance; Jean-Jacques Grob; Laurent Mortier; Adil Daud; Matteo S Carlino; Catriona McNeil; Michal Lotem; James Larkin; Paul Lorigan; Bart Neyns; Christian Blank; Teresa M Petrella; Omid Hamid; Honghong Zhou; Scot Ebbinghaus; Nageatte Ibrahim; Caroline Robert Journal: Lancet Date: 2017-08-16 Impact factor: 79.321
Authors: Jeremy M O'Connor; Kristen L Fessele; Jean Steiner; Kathi Seidl-Rathkopf; Kenneth R Carson; Nathan C Nussbaum; Emily S Yin; Kerin B Adelson; Carolyn J Presley; Anne C Chiang; Joseph S Ross; Amy P Abernethy; Cary P Gross Journal: JAMA Oncol Date: 2018-08-09 Impact factor: 31.777
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: James D Harrison; Jane M Young; Melanie A Price; Phyllis N Butow; Michael J Solomon Journal: Support Care Cancer Date: 2009-03-25 Impact factor: 3.603
Authors: H M Dhillon; M L Bell; H P van der Ploeg; J D Turner; M Kabourakis; L Spencer; C Lewis; R Hui; P Blinman; S J Clarke; M J Boyer; J L Vardy Journal: Ann Oncol Date: 2017-08-01 Impact factor: 32.976
Authors: Mbathio Dieng; Nadine A Kasparian; Rachael L Morton; Graham J Mann; Phyllis Butow; Scott Menzies; Daniel S J Costa; Anne E Cust Journal: BMC Psychol Date: 2015-07-11
Authors: Ana Carolina B Leme; Jess Haines; Lisa Tang; Karin L L Dunker; Sonia T Philippi; Mauro Fisberg; Gerson L Ferrari; Regina M Fisberg Journal: Nutrients Date: 2020-10-14 Impact factor: 5.717
Authors: Evie E M Kolsteren; Esther Deuning-Smit; Alanna K Chu; Yvonne C W van der Hoeven; Judith B Prins; Winette T A van der Graaf; Carla M L van Herpen; Inge M van Oort; Sophie Lebel; Belinda Thewes; Linda Kwakkenbos; José A E Custers Journal: Cancers (Basel) Date: 2022-08-11 Impact factor: 6.575
Authors: Amelia Hyatt; Karla Gough; Andrew Murnane; George Au-Yeung; Tamara Dawson; Elizabeth Pearson; Haryana Dhillon; Shahneen Sandhu; Narelle Williams; Elizabeth Paton; Alex Billett; Anya Traill; Hayley Andersen; Victoria Beedle; Donna Milne Journal: BMJ Open Date: 2020-02-28 Impact factor: 2.692