Use of the Pallia 10 score in patients enrolled in phase I trials at Gustave Roussy Cancer Center.

23 Background: Early phase clinical trials usually include patients (pts) with advanced disease who have failed to standard therapies. Early palliative care (EPC) for these pts has shown to improve quality of life and even survival. Pallia 10 score (from 1 to 10) is a tool developed by the French Palliative Care Society to identify the best time to introduce palliative care. Methods: We assessed the Pallia 10 score and other prognostic factors (age, ECOG, Royal Marsden Hospital (RMH) score, LDH and albumin levels, number (nb) of prior systemic treatments and metastatic sites) in pts enrolled in phase I trials (P1CT) prospectively during 2 periods of time (cohort 1 (C1) and 2 (C2)). A double-blind assessment of the Pallia 10 score was done during 15 days by a member of the palliative care unit in C2. A Pallia 10 > 3 motivated a dedicated palliative care consultation. Results: From 01/07/2018 to 01/11/2018 (C1) and from 01/12/2020 to 16/04/2021 (C2), a total of 85 pts were assessed in C1 and 302 in C2. Gastro-intestinal (23%), hematological (14%) and lung (11%) cancer were the most frequent tumor types. Pallia 10 score and prognostic factors were similar between both cohorts (Table). On C1 and C2, 12% and 4% of pts had a dedicated palliative consultation with median time of referral of 18 and 2 months (m) after the P1CT onset (p = 0.003), with a median Pallia 10 score of 1.5 and 2 (p = 0.65), respectively. Overall, 75% and 76% of pts in C1 and C2 were still alive beyond 3m after discontinuation of the P1CT (p = 0.91), followed by at least one subsequent treatment in 56% and 54% of pts. In C2, assessment of Pallia 10 score was significantly different between palliative care physician (median 5, range 3-8), phase I physician (median 1, range 1 -6) and phase I nurse (median 3, range 1-8) (p < 0.001). Conclusions: Only a few patients included in P1CT were referred to the palliative care unit. Median Pallia 10 score was low when assessed by the phase I physician which suggests the need for a better tool to implement EPC in clinical practice and trials.[Table: see text]

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Use of the PALLIA 10 Score in Patients Enrolled in Phase I Trials at Gustave Roussy Cancer Center

10.21203/rs.3.rs-1141116/v1 ◽

2022 ◽

Author(s):

Kaïssa Ouali ◽

Cristine Mateus ◽

Arianne Laparra ◽

Elena Pavliuc ◽

Patricia Martin-Romano ◽

...

Keyword(s):

Palliative Care ◽

Prognostic Factors ◽

Phase I ◽

Palliative Care Unit ◽

Cancer Center ◽

Phase I Trials ◽

Double Blind ◽

Early Palliative Care ◽

Palliative Care Consultation ◽

Systemic Treatments

Abstract Background Early phase clinical trials usually include patients with advanced disease who have failed standard therapies. Early palliative care for these patients has shown to improve quality of life and even survival. PALLIA 10 score (ranging from 1 to 10) is a tool developed by the French Palliative Care Society to identify the best time to introduce palliative care. Methods We assessed the PALLIA 10 score and other prognostic factors (age, ECOG, Royal Marsden Hospital (RMH) score, LDH and albumin levels, number of prior systemic treatments and metastatic sites) in patients enrolled in phase I trials at Gustave Roussy Cancer Center prospectively during 2 periods of time (cohort 1 (C1) and 2 (C2)). A double-blind assessment of the PALLIA 10 score was done during 15 days by a member of the palliative care unit in C2. A PALLIA 10 > 3 motivated a dedicated palliative care consultation. Results From July 1st 2018 to November 1st 2018 (C1) and from December 1st 2020 to April 16th 2021 (C2), a total of 86 patients were assessed in C1 and 302 in C2. No difference was observed between the two cohorts regarding prognostic factors. Median PALLIA 10 was also similar and very low (median 1, range 1-5 in C1 and 1-8 in C2). On C1 and C2, 12% and 5% of patients had a dedicated palliative consultation. Overall, 77% and 74% of patients in C1 and C2 were still alive beyond 3 months after discontinuation of the trial (p=0.78), followed by at least one subsequent treatment in 63% and 70% of pts. In C2, assessment of PALLIA 10 score was significantly different between palliative care physician (median 5, range 3-8), phase I physician (median 1, range 1 -6) and phase I nurse (median 3, range 1-8) (p<0.001). Conclusion Only a few patients included in phase I clinical trial were referred to the palliative care unit. Median PALLIA 10 score was low when assessed by the phase I physician which suggests the need for a better tool to implement early palliative care in clinical practice and trials.

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Antineoplastic therapy use in patients with advanced cancer admitted to an acute palliative care unit at a comprehensive cancer center

Cancer ◽

10.1002/cncr.24942 ◽

2010 ◽

Vol 116 (8) ◽

pp. 2036-2043 ◽

Cited By ~ 34

Author(s):

David Hui ◽

Ahmed Elsayem ◽

Zhijun Li ◽

Maxine De La Cruz ◽

J. Lynn Palmer ◽

...

Keyword(s):

Palliative Care ◽

Antineoplastic Therapy ◽

Advanced Cancer ◽

Palliative Care Unit ◽

Comprehensive Cancer Center ◽

Cancer Center

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Interval between first palliative care consultation and death among patients in a comprehensive cancer center in Saudi Arabia

Journal of Health Specialties ◽

10.4103/1658-600x.156107 ◽

2015 ◽

Vol 3 (2) ◽

pp. 61 ◽

Cited By ~ 3

Author(s):

SamiAyed Alshammary ◽

Abdullah Alsuhail ◽

BalajiP Duraisamy ◽

Savithiri Ratnapalan ◽

SaadHamad Alabdullateef

Keyword(s):

Palliative Care ◽

Saudi Arabia ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Palliative Care Consultation ◽

Care Consultation

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Frequency, Timing, and Predictors of Palliative Care Consultation in Patients with Advanced Cancer at a Tertiary Cancer Center: Secondary Analysis of Routinely Collected Health Data

The Oncologist ◽

10.1634/theoncologist.2019-0384 ◽

2020 ◽

Vol 25 (8) ◽

pp. 722-728 ◽

Cited By ~ 1

Author(s):

Sharon M. Watanabe ◽

Viane Faily ◽

Asifa Mawani ◽

Ann Huot ◽

Yoko Tarumi ◽

...

Keyword(s):

Palliative Care ◽

Advanced Cancer ◽

Secondary Analysis ◽

Health Data ◽

Cancer Center ◽

Palliative Care Consultation ◽

Routinely Collected Health Data ◽

Care Consultation ◽

Tertiary Cancer Center

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Palliative Care Consultation Service and Palliative Care Unit: Why Do We Need Both?

The Oncologist ◽

10.1634/theoncologist.2011-0326 ◽

2012 ◽

Vol 17 (3) ◽

pp. 428-435 ◽

Cited By ~ 22

Author(s):

Jan Gaertner ◽

Sebastian Frechen ◽

Markus Sladek ◽

Christoph Ostgathe ◽

Raymond Voltz

Keyword(s):

Palliative Care ◽

Palliative Care Unit ◽

Consultation Service ◽

Palliative Care Consultation ◽

Care Consultation ◽

Palliative Care Consultation Service

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Hope and Persuasion by Physicians During Informed Consent

Journal of Clinical Oncology ◽

10.1200/jco.2014.55.2588 ◽

2014 ◽

Vol 32 (29) ◽

pp. 3229-3235 ◽

Cited By ~ 32

Author(s):

Victoria A. Miller ◽

Melissa Cousino ◽

Angela C. Leek ◽

Eric D. Kodish

Keyword(s):

Palliative Care ◽

Informed Consent ◽

Phase I ◽

Phase I Trial ◽

Physician Communication ◽

Phase I Trials ◽

Positive Outcomes ◽

Parent Ratings ◽

Persuasive Messages ◽

Perceived Pressure

Purpose To describe hopeful and persuasive messages communicated by physicians during informed consent for phase I trials and examine whether such communication is associated with physician and parent ratings of the likelihood of benefit, physician and parent ratings of the strength of the physician's recommendation to enroll, parent ratings of control, and parent ratings of perceived pressure. Patients and Methods Participants were children with cancer (n = 85) who were offered a phase I trial along with their parents and physicians. Informed consent conferences (ICCs) were audiotaped and coded for physician communication of hope and persuasion. Parents completed an interview (n = 60), and physicians completed a case-specific questionnaire. Results The most frequent hopeful statements related to expectations of positive outcomes and provision of options. Physicians failed to mention no treatment and/or palliative care as options in 68% of ICCs and that the disease was incurable in 85% of ICCs. When physicians mentioned no treatment and/or palliative care as options, both physicians and parents rated the physician's strength of recommendation to enroll in the trial lower. Conclusion Hopes and goals other than cure or longer life were infrequently mentioned, and a minority of physicians communicated that the disease was incurable and that no treatment and/or palliative care were options. These findings are of concern, given the low likelihood of medical benefit from phase I trials. Physicians have an important role to play in helping families develop alternative goals when no curative options remain.

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