Relationship between neutrophils/lymphocytes and tumor infiltrating lymphocytes stroma in patients with invasive muscle bladder cancer and the response to treatment.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16513-e16513
Author(s):  
Martin Eduardo Richardet ◽  
Maria gimena Ferreira ◽  
Martin Paradelo ◽  
Luciana Paola Acosta ◽  
Matias Molina ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Predictive Factor ◽  
Objective Response ◽  
Neoadjuvant Treatment ◽  
High Body Mass Index ◽  
Response To Treatment ◽  
Number Of Patients ◽  
The Difference ◽  
Tract Infections ◽  
Infiltrating Lymphocytes

e16513 Background: The bladder cancer is a malignant disease. It has been related to tobacco consumption, fat diet, high body mass index (BMI) and urinary tract infections. As a result of the activation the pro-inflammatory pathways. Neutrophil to lymphocyte radio (NLR) and the infiltrating lymphocytes of the tumor stroma (TILs) have been shown to have a significant prognostic value in different tumors. The primary aim is to analyze the role of TILs and RNL as a predictive factor, in patients with MIBC and objective response rate (ORR). The secondary aim is to evaluate the relationship beteween BMI, tabaquism and ORR, in the same group of pts. Methods: A total of 35 pts with MIBC was included. All pts received neoadjuvant treatment, with cisplatin and gemcitabine. Also, TILs was determined as the percentage of mononuclear inflammatory cells in the total stromal area counted in 5 high-power fields (CGA, X 400), on the invasive front of the tumor. The NLR was obtained before treatment and value of cut-off was 2.6. the evaluation of ORR was calculated used the T-Test and Chi Square test. Results: Of the total of 35 patients. 15 patients obtained complete response (CR), 6 pts partial response (PR), 5 pts stable disease (SD) and 9 pts disease progression (DP). In 21 tumor sample was observed an intense TILS. These patients obtained a better ORR 42.6 % vs 21.7% with low TILs in his tumor samples. The difference was statistically significant (p: 0.001). Regarding NLR, only 9 pts presented response with NLR > 2,6 vs 12 pts with response and RNL < 2.6. The difference was not statistically significant. When analyzing the smoking and response. We could observe response of 69.6% in smoking pts vs Non- smoking the response was 41.7%. Regarding BMI, 21 pts with response of 27% and 14 patient without response 25.9%. But the differences were not significant in any groups. Conclusions: We conclude that the presence of TILS in tumor samples, in patients with MIBC, could be a predictive factor against the response to neoadjuvant treatment. With the other variables, smoking and BMI, we did not observed influence in ORR. We will keep working to obtain a greater number of patients. Then we could have a better analysis and statistical power.

Neutrophil-lymphocyte radio (NLR) as a possible predictive factor in patients with advanced NSCLC WHO received immunotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21042-e21042
Author(s):  
Eduardo Richardet ◽  
Luciana Paola Acosta ◽  
Maria gimena Ferreira ◽  
Ignacio Magi ◽  
Rocio tello Alfonso ◽  
...  
Keyword(s):  
General Population ◽  
Predictive Factor ◽  
Statistical Power ◽  
Advanced Nsclc ◽  
Combined Treatment ◽  
Objective Response ◽  
Strong Relationship ◽  
Neutrophil Lymphocyte Ratio ◽  
Platinum Based Chemotherapy ◽  
Number Of Patients

e21042 Background: There exists a strong relationship between cancer and inflammation. For this reason, attempts have been made to identify different biomarkers of inflammation in recent years. The neutrophil - lymphocyte ratio (NLR) a marker of systemic inflammation, and the infiltranting lymphocytes of the tumor stroma (TILs) have been studied by our research team in different tumors, such as melanoma, breast cancer, colon cancer and NSCLC in patient who had recieved tratment with chemotherapy. We could observe that there was a significant relationship beteween DFS and a high NLR on the one hand, and DSF an intense TILs on the other. Our main objective is to evaluate the relationship between the objective response rate (ORR) and the pretreatment NLR in patients with advanced NSCLC who recieved immunotherapy. Our secondary objective is to analyzed the associated between PFS and RNL in patients with advanced NSCLC undergoing immunotherapy. Methods: Patients with diagnosis of advanced-stage NSCLC who recieved only immunotherapy, immunotherapy with another immunomodulator or in combination with platinum-based chemotherapy werw included. All patients had a follow-up of at least 6 months. The cutoff value > or < 3 for the NLR was use to reference. The laboratory control prior to the beginning of treatment was taken, and the ORR was determined using the Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Statistical analysis was performed using dispersion and position measurements, T-Test and Chi Square test. For PFS analysis Kaplan-Meyer was used. The level of significance for the variables was p < 0.05. Results: 41 patients with advanced NSCLC were analyzed. 43.9% (18 pts) recieved immunotherapy alone with nivolumab. 34.14% (14 pts) received a combined treatment (nivo / ipi) and 21.95% (9 pts.), immuno / QT combination (based on platinum). Regarding the histological presentation, 80.48% were adenocarcinoma. 54% (22 pts) had an NLR > 3 and 46% (19 pts) an NLR < 3. The ORR in the general population was 24%. in pts with an NLR < 3, the ORR that was observed was 42% vs. ORR of 9% in pts with NLR > 3 (p: 0.02). These differences were statistically significant. The median PFS was 11.27 months in the general population. As regards RNL, the median PFS were 20.74 vs 5.52 months in favor of pts with an NLR < 3 (p: 0.04). Conclusions: We could conclude that patients with NSCLC and pretreatment NLR < 3, who undergo immunotherapy, had better ORR compared to those with NLR > 3. These differences was statistically significant. Also, we could observe better PFS in patient with NLR < 3. These difference was estatically significant. We will keep working to obtain a greater number of patients. Then we could have a better analysis and statistical power. It is possible that NLR will be a highly useful and easy-to-acces predictive factor, and it could be used in patients with immunotherapy in our daily practice.

scholarly journals EFFICACY OF INTRAVESICAL INSTILLATION OF NETILMICIN ON MANAGING UTI

2015 ◽  
Vol 22 (1) ◽  
Author(s):  
Barry Arief Praba ◽  
Trisula Utomo
Keyword(s):  
Antimicrobial Agents ◽  
Severe Infection ◽  
Intravesical Instillation ◽  
Urethral Catheter ◽  
Response To Treatment ◽  
Chi Square ◽  
Indwelling Catheter ◽  
The Difference ◽  
Group 2 ◽  
Tract Infections

INTRODUCTION Urinary tract infections (UTIs) are common, affect men and women of all ages, and vary dramatically in their presentation and sequelae. They are a common cause of morbidity and can lead to significant mortality. New antimicrobial agents that achieve high urinary and tissue levels, that can be administered orally, and that are not nephrotoxic have significantly reduced the need for hospitalization for severe infection. Shorter-course therapy and prophylactic antimicrobial agents have reduced the morbidity and cost associated with recurrent cystitis in women. Intravesical instillation of aminoglycoside has been used empirically as prophylaxis and to treat bacilluria in spinal-cord-injured patients undergoing clean intermittent catheterization.METHODS In a prospective clinical trial performed in the urologic ward of Dr. Sardjito Hospital, yogyakarta, Indonesia, we studied 56 patients who has indwelling urethral catheter more than 4 days. Patients were divided into two groups. In group 1 (28 patients) one-time intravesical instillation of Netilmicin 25 mg was administred, and in group 2 (28 patients) none were given any treatment. Urinalysis was evaluated before and after instillation of Netilmicin. Statistical data and results were studied using descriptive statistics as median (minimum and maximum). To compare the response to treatment, Chi-Square test was used in two groups. Consequently, the data were analyzed using the SPSS 17 software.RESULTS Urinalysis were evaluated in two groups 4 days after intravesical instillation of 50 mg netilmicin. The patients we studied, the median age 59 years old (min. 29; max. 81). In the first group we found 22 (78,5 %) patients still without UTI, 6 (21,5 %) patients with UTI, in the second group we found 4 (14,3 %) still without UTI, 24 (85,7 %) patients with UTI. The difference was statistically significant (p=0.0001)CONCLUSIONS Intravesical instillation of netilmicin on patients with indwelliing urethral catheter were effective on preventing catheter-related UTI.Keywords : UTI, indwelling catheter, netilmicin, intravesical antibiotic instillation.

MGMT expression correlates with response rate and survival in patients with inoperable glioblastoma (GBM) treated with neoadjuvant temozolomide (TMZ)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1574-1574
Author(s):  
M. Barrie ◽  
N. Eudes ◽  
P. Metellus ◽  
S. Fuentes ◽  
S. Honore ◽  
...  
Keyword(s):  
Response Rate ◽  
Alkylating Agents ◽  
Objective Response ◽  
Neoadjuvant Treatment ◽  
Antigen Retrieval ◽  
Repair Gene ◽  
Mgmt Expression ◽  
Therapeutic Decisions ◽  
Dna Repair Gene ◽  
Number Of Patients

1574 Background: Methylation of the promotor of O6-alkylguanine alkyltransferase (MGMT), a DNA repair gene, may enhance chemosensitivity to alkylating agents. In GBM, this methylation has been correlated to survival as well as to the benefit of adding TMZ concomitant and adjuvant to radiotherapy (RT) (Hegi, NEJM, 2005). We examine the relationship between MGMT expression and objective response rate to dose intense TMZ schedule administered as neoadjuvant treatment before RT in inoperable GBM, as previously presented (Chinot, ASCO, 2005). Methods: Thirty patients were included in this phase II trial that tested TMZ (150 mg/m2/day) on days 1 to 7 and 15 to 21 of each 28 days cycle for up to 4 cycles prior to RT. We analysed retrospectively MGMT expression by immunochemistry (streptavidin-peroxydase) after antigen retrieval using anti-MGMT antibody (Abcys, 1/100) in 25 formalin-fixed paraffin embedded samples from the study population. Results: In the eligible population (n = 28) response rates (RR) were of 25% (95% CI, 8.63% to 41.37%); SD 32%; PD 43%. Median progression free survival (PFS) and overall survival (OS) were 3.8 and 5.8 months, respectively. MGMT expression was analysed in 25 pts while material was considered as inadequate in 3 pts because of insufficient tumor material. The median percentage of cells that expressed MGMT in tumor nuclei was 35% and so was chosen as cut-off. Low MGMT expression was significantly associated with a high RR (55%) while tumor that exhibit high MGMT expression was associated to a RR of 9% (chi-2 p=0.004). MGMT was also strongly correlated to PFS (log rank p=0.009) and OS (log rank p=0.003). Conclusion: Despite limited number of patients, our study strongly supports the predictive value of MGMT expression for objective response to TMZ in addition to its prognostic value for PFS and OS in GBM. If confirmed in prospective study, MGMT expression may help to guide therapeutic decisions as well as more targeted trial design. [Table: see text] No significant financial relationships to disclose.

MC (cisplatin and methotrexate) adjuvant chemotherapy after cystectomy versus MC neoadjuvant chemotherapy following cystectomy in locally advanced bladder cancer: Results after 10 years of experience

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 150-154
Author(s):  
L Rigoni ◽  
V. Scattoni ◽  
P. Rovellini ◽  
G. Pavia ◽  
A. Bottanelli ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Clinical Staging ◽  
Number Of Patients ◽  
Significant Difference ◽  
Advanced Bladder Cancer

— We report the results of a retrospective study of two groups of patients affected by locally advanced bladder cancer: the first group was submitted to adjuvant chemotherapy with Cisplatin and Methotrexate after cystectomy and the second group was submitted to neoadjuvant chemotherapy with the same scheme following radical cystectomy. The validity of the study is given by the homogeneity of the two groups for period of recruitment, number of patients, patient's age, stage of disease and treatment. The overall survival of 5 years in the first group was 30%, while the 5-year survival rate of the second group was 38%, 63% and 17% for all the patients, the responders and the nonresponders respectively. No significant difference in terms of survival was found between the two groups, but the results of the neoadjuvant approach may be influenced by clinical staging errors. The chemosensitivity, that can be assessed only with the neoadjuvant treatment, is the main prognostic factor.

scholarly journals Health Problems among Disciplines at a Regional University in Southern Thailand: A Descriptive Study

2020 ◽  
Author(s):  
Supakorn Sripaew ◽  
Chanon Kongkamol
Keyword(s):  
Incidence Rate ◽  
Traffic Accidents ◽  
Skin Diseases ◽  
Health Problems ◽  
Upper Respiratory Tract ◽  
Health Issues ◽  
Number Of Patients ◽  
Common Problems ◽  
The Difference ◽  
Tract Infections

Objective: To determine incidence of various health problems among Prince of Songkla University (PSU) students, and its distribution among disciplines. Material and Methods: A Retrospective study, collecting secondary de-identified hospital records of 45,093 PSU students, over the 6-year period of study; from 1st, January 2012 to 31st, December 2017. Results: According to data from 45,093 students, there were 8 groups of influential health problems that were shared in approximately 80 percent of all diagnoses. Acute upper respiratory tract infections played the greatest incidence among all disease groups. Apart from that, common health issues found in adolescence consisted of; common skin diseases, traffic accidents, and diseases of the digestive system also played a part as the most common problems. Even if the traffic accidents rate seemed to be overlooked by its number, its incidence rate was 17.41 per 1,000, which was above the provincial rate as well as country rate. Disciplines in the medical group and freshmen group were the highest of patients having most of the common problems. Each health problem incidence rate, which varied within the university campus, seemed to be from the difference of disease burden among disciplines; rather than the ease of facility accessibility. Conclusion: The collegians experienced wide ranges of common health problems, which were predominated in adolescents, and adults. Medical sciences students and freshmen were the highest number of patients for almost all health issues. Overall, health problems among the collegians probably varied in the campus due to specific characteristics in each disciplines, and differed as to the different context in other universities.

Baseline apparent diffusion coefficients: Validation study of new predictor of survival in patients with unresectable hepatocellular carcinoma following chemoembolization

2021 ◽  
pp. 1-10
Author(s):  
Lichao Xu ◽  
Shiqin Wang ◽  
Shengping Wang ◽  
Ying Wang ◽  
Wentao Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Roc Curve ◽  
Cox Regression ◽  
Response To Treatment ◽  
Roc Curve Analysis ◽  
Adc Value ◽  
Apparent Diffusion Coefficients ◽  
Apparent Diffusion ◽  
Response Biomarker ◽  
The Difference

OBJECTIVES: To investigate whether the baseline apparent diffusion coefficient (ADC) can predict survival in the hepatocellular carcinoma (HCC) patients receiving chemoembolization. MATERIALS AND METHODS: Diffusion-weighted MR imaging of HCC patients is performed within 2 weeks before chemoembolization. The ADC of the largest index lesion is recorded. Responses are assessed by mRECIST after the start of the second course of chemoembolization. Receiver operating characteristic (ROC) curve analysis is performed to evaluate the diagnostic performance and determine optimal cut-off values. Cox regression and Kaplan–Meier survival analyses are used to explore the differences in overall survival (OS) between the responders and non-responders. RESULTS: The difference is statistically significant in the baseline ADC between the responders and non-responders (P <  0.001). ROC analyses indicate that the baseline ADC value is a good predictor of response to treatment with an area under the ROC curve (AUC) of 0.744 and the optimal cut-off value of 1.22×10–3 mm2/s. The Cox regression model shows that the baseline ADC is an independent predictor of OS, with a 57.2% reduction in risk. CONCLUSION: An optimal baseline ADC value is a functional imaging response biomarker that has higher discriminatory power to predict tumor response and prolonged survival following chemoembolization in HCC patients.

scholarly journals 353 Safety and efficacy of tumor infiltrating lymphocytes (TIL, LN-145) in combination with pembrolizumab for advanced, recurrent or metastatic HNSCC

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A378-A378
Author(s):  
Antonio Jimeno ◽  
Sophie Papa ◽  
Missak Haigentz ◽  
Juan Rodríguez-Moreno ◽  
Julian Schardt ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Checkpoint Inhibitors ◽  
Adoptive Cell Therapy ◽  
Single Agent ◽  
Objective Response ◽  
Tumor Resection ◽  
Tumor Infiltrating Lymphocytes ◽  
Open Label ◽  
Safety And Efficacy ◽  
Infiltrating Lymphocytes

BackgroundSingle agent checkpoint inhibitors (CPI) are an approved first or second-line therapy in head and neck squamous cell carcinoma (HNSCC), but their efficacy is limited. Adoptive cell therapy with tumor infiltrating lymphocytes (TIL, LN-145) has demonstrated efficacy in multiple malignancies alone or in combination with CPI. To improve HNSCC therapy, a combination of pembrolizumab and LN-145 was explored.MethodsIOV-COM-202 is an ongoing Phase 2 multicenter, multi-cohort, open-label study evaluating LN-145 in multiple settings and indications, and here we report cohort 2A which enrolled CPI naïve HNSCC patients who received the combination of LN-145 and pembrolizumab. Key eligibility criteria include up to 3 lines of prior therapy, ECOG <1, at least one resectable metastasis for LN-145 production, and at least another measurable lesion after tumor resection. Primary endpoints are ORR per RECIST v1.1 by investigator and safety as measured by the incidence of grade ≥ 3 treatment-emergent adverse events (TEAEs). LN-145 production method uses central GMP manufacturing in a 22-day process yielding a cryopreserved TIL product (figure 1). Preconditioning chemotherapy consists of cyclophosphamide/fludarabine, followed by LN-145, and then < 6 doses of IL-2 over <3 days. Pembrolizumab is initiated post-tumor harvest but prior to LN-145 and continues after LN-145 infusion Q3W until toxicity or progression (figure 2).ResultsNine (N=9) HNSCC patients have received LN-145 plus pembrolizumab, with a median duration of follow up of 6.9 months. Nine and 8 patients were evaluable for safety and efficacy, respectively. Mean number of prior therapies was 1.1 with 89% of the patients having received prior chemotherapy. Four were HPV+, 2 HPV-, 3 unknown. The Treatment Emergent Adverse Event (TEAE) profile was consistent with the underlying advanced disease and the known AE profiles of pembrolizumab, the lymphodepletion and IL-2 regimens. The most common TEAE were chills, hypotension, anemia, thrombocytopenia, pyrexia, fatigue and tachycardia. Four patients had a confirmed, objective response with an ORR of 44% (1 CR, 3 PR, 4 SD, 1 NE) per RECIST 1.1. The disease control rate at data cutoff was 89% in 9 patients, and 7 of the 8 evaluable patients (87.5%) had a reduction in target lesions. Median DOR was not reached.Abstract 353 Figure 1Iovance LN-145 (autologous TIL cell therapy product) ManufacturingAbstract 353 Figure 2IOV-COM-202 Study SchemaConclusionsLN-145 can be safely combined with pembrolizumab in patients with metastatic HNSCC. LN-145 plus pembrolizumab shows early signs of improved efficacy particularly when compared with literature reports of pembrolizumab alone in a comparable patient population. Enrollment is ongoing and updated data will be presented.Trial RegistrationNCT03645928Ethics ApprovalThe study was approved by Advarra Institutional Review Board, under protocol number: Pro00035064.

scholarly journals Precision immunity: Immunoscore and neoadjuvant treatment in bladder cancer

2021 ◽  
Vol 10 (1) ◽  
pp. 1888488
Author(s):  
Elise F. Nassif ◽  
Constance Thibault ◽  
Stéphane Oudard ◽  
Jérôme Galon
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Treatment

scholarly journals 216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
Christina Maguire ◽  
Dusten T Rose ◽  
Theresa Jaso
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Source Control ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Before And After ◽  
The Difference ◽  
Tract Infections ◽  
Length Of Therapy ◽  
The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

Planning for End of Life

2021 ◽  
pp. 104990912110141
Author(s):  
Natasha Ansari ◽  
Eric Johnson ◽  
Jennifer A. Sinnott ◽  
Sikandar Ansari
Keyword(s):  
End Of Life ◽  
Treatment Options ◽  
Stage Iv ◽  
P Value ◽  
Life Planning ◽  
Number Of Patients ◽  
End Of Life Planning ◽  
The Difference ◽  
Alternative Medications ◽  
Patient’S Perception

Background: Oncology provider discussions of treatment options, outcomes of treatment, and end of life planning are essential to care for patients with advanced malignancies. Studies have shown that despite this, many patients do not have adequate care planning, including end of life planning. It is thought that the accessibility of information outside of clinical encounters and individual factors and/or beliefs may influence the patient’s perception of disease. Aims: The objective of this study was to evaluate if patient understanding of treatment goals matched the provider and if there were areas of discrepancy. If a discrepancy was found, the survey inquired further into more specific aspects. Methods: A questionnaire-based survey was performed at a cancer hospital outpatient clinic. 100 consecutive and consenting patients who had stage IV non-curable lung, gastrointestinal (GI), or other cancer were included in the study. Patients must have had at least 2 visits with their oncologist. Results: 40 patients reported their disease might be curable and 60 reported their disease was not curable. Patients who reported their disease was not curable were more likely to be 65 years or older (P-value: 0.055). They were more likely to report that their doctor discussed the possibility of their cancer getting worse (78.3% VS 55%; P-value 0.024), that their doctor discussed end of life plans (58.3% VS 30%; P- value: 0.01), and that they had appointed a health care decision-maker (86.7% VS 62.5%; P-value: 0.01). 65% of patients who thought their disease might be curable reported that their doctor said it might be curable, compared with only 6.7% of patients who thought their disease was not curable (p < 0.001). Or, equivalently, 35% of patients who thought their disease might be curable reported that their doctor’s opinion was that it was not curable, compared with 93% of patients who thought their disease was not curable (p < 0.001). Patients who had lung cancer were more likely to believe their cancer was not curable than patients with gastrointestinal or other cancer, though the difference was not statistically significant (p = 0.165). Patients who said their disease might be curable selected as possible reasons that a miracle (50%) or alternative medicine (66.7%) would get rid of the cancer, or said their family wanted them to believe the cancer would go away (16.7%) or that another doctor said it would (4.2%). Patients who said their disease might be curable said they did so due to alternative medications, another doctor, or their family. Restricting to the 70 patients who reported their doctors telling them their disease was not curable, 20% of them still said that they personally felt their disease might be curable. Patients below 65 years of age were more likely to disagree with the doctor in this case (P-value: 0.047). Conclusion: This survey of patients diagnosed with stage IV cancer shows that a significant number of patients had misunderstandings of the treatment and curability of their disease. Findings suggest that a notable proportion kept these beliefs even after being told by treating physicians that their disease is not curable.

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