Early and Multimodal Care for Patients with Lung Cancer: Findings from the ACCEPT Study

Objective: Treating lung cancer with a combination of targeted cancer therapy, supportive, and psychosocial treatments is important in modern oncology. The ACCEPT study investigated the efficacy of a 12-week early multimodal supportive care program on quality of life. Methods: ACCEPT was a single-center, non-randomized, prospective, open-label trial, with a pragmatic real-world design guided by patient choice. Patients with newly diagnosed, stage II-IV lung cancer participated in the outpatient ACCEPT program (psycho-oncology, health education, and training-based interventions alongside standard care). Longitudinal patient-reported outcome measures (PROMs) were collected. The primary outcome was the change in quality of life at 12 weeks measured by the Trial Outcome Index (TOI). Secondary outcomes included further exploratory PROM changes and overall survival. Results: Between April 2018 and August 2021, 214 lung cancer patients (median age 67, 53% male, 57% stage IV) were enrolled, with 116 patients evaluable for longitudinal PROM changes at 12 weeks. Participation in the multimodal ACCEPT program was associated with up to 17% improvement in the TOI, psychological distress, and sleep quality (p < 0.0001). Multivariate analyses revealed that greater session attendance was significantly and dose-dependently associated with improvements in the TOI as well as reductions in depression and anxiety. Higher engagement in multimodal sessions was also linked to reduced fatigue. Furthermore, exploratory signals of improved overall survival were observed among the 40 patients (18.7%) who fully completed the ACCEPT program. Conclusions: This pragmatic, patient-centered, multimodal supportive care program for lung cancer patients was associated with dose-dependent improvements in quality of life and psychological distress. While exploratory signals of improved survival were observed, multicenter randomized controlled trials are required to confirm these findings and firmly establish the role of such supportive care programs in routine oncology.