Perceptions of Prognosis and Hope Among Patients With Advanced Cancer at the Time of Enrollment in an Early-Phase...

Patients overestimate their likelihood of benefit from early phase clinical trials (EPCT). Concerns about taking away hope from patients represent a purported barrier to prognostic discussions. In this study, we aimed to assess prognostic perceptions and hope among patients with advanced cancer at the time of enrollment in an EPCT.

We enrolled patients at the time of EPCT enrollment at an academic medical center. Participants completed questionnaires assessing prognostic perceptions (Prognosis and Treatment Perceptions Questionnaire), hope (Herth Hope Index; range, 12-48, higher scores indicate higher hope), and symptoms (Edmonton Symptom Assessment System-Revised). We used descriptive statistics and regression models to explore associations of prognostic perceptions and hope.

Among 189 study participants (mean age = 62.5 years, 56.6% female, 93.1% White), 27.4% reported that the goal of their cancer treatment was to cure their cancer and 62.2% reported having conversations with their oncologist about prognosis. The majority (92.4%) reported that knowing about prognosis was extremely/very helpful. Patients' mean hope score was 39.1 (standard deviation, 5.1). We found no association between hope and perceptions of the intent of cancer therapy (B = -0.59, P = .486) or hope and patient-reported frequency of conversations with their oncologist about prognosis (B = -1.25, P = .125).

At the time of enrollment in an EPCT, we found no association between patients' hope and perception of the intent of cancer therapy or report of having discussed their prognosis with their oncologist. These findings suggest that patients can have hope despite acknowledging the noncurative intent of their therapy and prognostic discussions.