Palliative Care: A Supportive Adjunct to Pediatric Phase I Clinical Trials for Anticancer Agents?

PEDIATRICS ◽  
2004 ◽  
Vol 114 (3) ◽  
pp. 852-855 ◽  
Author(s):  
C. M. Ulrich
Author(s):  
Stephen Leong ◽  
Justin Call ◽  
Alex A. Adjei ◽  
Wells Messersmith

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 75-75
Author(s):  
Marisa R Moroney ◽  
Breana Hill ◽  
Jeanelle Sheeder ◽  
Jennifer Robinson Diamond ◽  
Melony Avella-Howell ◽  
...  

75 Background: ASCO guidelines recommend patients with advanced cancer receive early integrated specialty palliative care based on evidence of multiple clinical benefits. To our knowledge, there is no literature evaluating utilization of specialty palliative care in Phase I clinical trial patients, but there is limited data demonstrating underutilization of palliative care services in patients with life-threatening diseases including advanced cancer. Methods: A retrospective review of ovarian cancer patients enrolled in Phase I clinical trials at one institution from 2008 to 2018. Charts were reviewed for patient and disease characteristics including age, disease stage, number of chemotherapy regimens and date of death. Charts were also reviewed to determine if and when patients received specialty palliative care services. Results: A total of 121 patients with ovarian cancer were enrolled in Phase I clinical trials. Median age at time of Phase I enrollment was 59 years (range 33-88). 87% of patients had advanced stage disease: 60% Stage III and 27% Stage IV. Median number of chemotherapy regimens received prior to Phase I enrollment was 5 (range 1-13). Median survival was 311 days (95%CI 225.9-396.1). Of the 121 patients, 4 (3.3%) received specialty palliative care prior to Phase I enrollment, 7 (5.8%) within 30 days after enrollment, and 53 (43.8%) more than 30 days after enrollment. 57 patients (47.1%) never received specialty palliative care. Conclusions: Ovarian cancer patients enrolled in Phase I clinical trials have advanced cancer – defined by ASCO as disease that is late-stage and life limiting with a prognosis less than 24 months – and should therefore receive early integrated specialty palliative care. This study demonstrates that a significant portion of Phase I ovarian cancer patients are either receiving no or late integration of specialty palliative care. Further work needs to focus on increasing early integration of specialty palliative care in this population.


1994 ◽  
Vol 34 (6) ◽  
pp. 451-454
Author(s):  
Kuniaki Itoh ◽  
Yasutsuna Sasaki ◽  
Yoshifumi Miyata ◽  
Hirofumi Fujii ◽  
Tomoko Ohtsu ◽  
...  

2014 ◽  
Vol 17 (12) ◽  
pp. 1365-1368 ◽  
Author(s):  
Virginia Sun ◽  
Liz Cooke ◽  
Vincent Chung ◽  
Gwen Uman ◽  
Thomas J. Smith ◽  
...  

1994 ◽  
Vol 34 (6) ◽  
pp. 451-454 ◽  
Author(s):  
Kuniaki Itoh ◽  
Yasutsuna Sasaki ◽  
Yoshifumi Miyata ◽  
Hirofumi Fujii ◽  
Tomoko Ohtsu ◽  
...  

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 138-138 ◽  
Author(s):  
Betty R. Ferrell ◽  
Vincent M. Chung ◽  
Marianna Koczywas ◽  
Anna Cathy Williams ◽  
Arti Hurria ◽  
...  

138 Background: Cancer patients receiving Phase I clinical trials are a population with advanced disease, high symptom burden, and with multiple QOL concerns including use of advance directives. Methods: An NCI funded R01 is currently in progress (2014-2019) as a randomized clinical trial to test a palliative care intervention (PCI) in this population. The PCI includes comprehensive patient assessment, goals of care communication, interdisciplinary care planning and patient teaching. Aims and hypotheses test the impact of the PCI on symptoms, QOL, resource use, spirituality and distress. Outcomes for the study (N = 400) will be conducted at the conclusion of the RCT. This paper reports preliminary baseline data of the first 100 subjects accrued. Results: Subjects mean age was 59 years and 59% were female, similar to prior trials. Forty eight percent (48%) were ethnic minorities, higher than prior trials (3% non-white, Finlay E, 2014; 9%, Parsons JA, et al. PLoS One 2012) with colon (22%) and lung (21%) cancers as dominant. Patients had a mean of 2 comorbidities (range 0-8) and 40% of the patients are > 65 years of age. The most common symptoms reported by PRO-CTCAE (1 = least to 5 = most concern) were sexuality (4.2), fatigue (2.9), pain (2.6) and anxiety (2.5). Psychological Distress Thermometer, (0 - least to 10 = most distress) mean score was 4. FACIT spiritual concerns (1 = least to 5 = most concerning) identified greatest concerns of illness strengthening faith (2.0), strength from faith (2.0) and sense of harmony (2.6). There was limited use of supportive care services, PC consultation, or advanced directives. Conclusions: The population of Phase I trial patients is an important group for palliative care integration with major unmet needs in symptom management and advance care planning.


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