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Do Patients Regret Having Received Systemic Treatment for Advanced Non-Small Cell Lung Cancer: A Prospective
Patricia J Hollen1, Richard J Gralla2, Ryan D Gentzler1
1University of Virginia, Charlottesville, Virginia, USA.
The Oncologist
|October 24, 2020
Summary
Patient regret after advanced non-small cell lung cancer treatment is linked to worsening health status. Early identification of at-risk patients allows for timely interventions to address regret.
Area of Science:
- Oncology
- Patient-Reported Outcomes
- Cancer Treatment Decision-Making
Background:
- Advanced non-small cell lung cancer (NSCLC) treatment decisions are common, yet patient regret is understudied.
- This study prospectively assessed regret incidence and predictors in advanced NSCLC patients.
Purpose of the Study:
- To evaluate the incidence of treatment-related regret in advanced NSCLC patients.
- To identify predictors of regret, including baseline characteristics, decision parameters, and early clinical progress.
Main Methods:
- 164 advanced NSCLC patients were enrolled; 142 were evaluated for regret at 3 months.
- Patient-reported outcomes (PROs) using the electronic Lung Cancer Symptom Scale (eLCSS-QL) and 3-Item Global Index (3-IGI) were collected every 3 weeks.
- Patients were randomized to usual care or enhanced care with a decision aid.
Main Results:
- 11.5% of patients and 9% of supporters reported regret.
- Regret was not predicted by baseline characteristics.
- Worsening 3-IGI scores (a PRO) after two cycles predicted regret (14% vs 1% for stable/improved scores, p=.01).
Conclusions:
- The majority of regret was identified early using PROs (eLCSS-QL 3-IGI).
- Identifying patients at risk for regret enables early interventions, such as discussing treatment progress and goals.
- Proactive counseling addressing potential treatment changes is crucial for patients experiencing worsening health status.
