Cancer patients' experiences with immune checkpoint modulators: A qualitative study.


Journal

Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310

Informations de publication

Date de publication:
05 2020
Historique:
received: 06 08 2019
revised: 24 01 2020
accepted: 25 01 2020
pubmed: 3 3 2020
medline: 15 5 2021
entrez: 3 3 2020
Statut: ppublish

Résumé

Minimal qualitative data exist on the experiences of cancer patients treated with immune checkpoint inhibitors or costimulatory antibodies. Understanding the day to day experiences of patients being treated with immune checkpoint modulators, and how these relate to their health-related quality of life, can inform future research and lead to better clinical decision-making and care. We report here the first in depth qualitative study to consider patients' diverse and complex experiences with immune checkpoint modulators, with a focus on side effects and how these impact daily life. This single-center qualitative study was based on focus groups and semistructured interviews. Patients who were being treated or who had been treated with immune checkpoint modulators within the last year for a range of cancer diagnoses were recruited. Interpretive description informed our inductive, iterative approach to analysis. Eight themes were identified, characterizing the complexity of these patients' lived experiences: major categories of side effects experienced and how they impacted patient well-being; the heterogeneous nature of side effects experienced; living with uncertainty; reframing the meaning and severity of SEs; focus on survival, hope, and being positive; acceptance and adaptation; feeling supported; and faith in medical innovation. Throughout their accounts, participants highlighted the profound impact that immune checkpoint modulators had on their daily lives. This is the first in-depth qualitative study into patient accounts of their experiences of treatment with immune checkpoint modulators, related side effects, and how it impacted their daily lives. This research is an integral initial step in developing an instrument that will assess treatment-related side effects in patients treated with this form of therapy.

Sections du résumé

BACKGROUND
Minimal qualitative data exist on the experiences of cancer patients treated with immune checkpoint inhibitors or costimulatory antibodies. Understanding the day to day experiences of patients being treated with immune checkpoint modulators, and how these relate to their health-related quality of life, can inform future research and lead to better clinical decision-making and care. We report here the first in depth qualitative study to consider patients' diverse and complex experiences with immune checkpoint modulators, with a focus on side effects and how these impact daily life.
METHODS
This single-center qualitative study was based on focus groups and semistructured interviews. Patients who were being treated or who had been treated with immune checkpoint modulators within the last year for a range of cancer diagnoses were recruited. Interpretive description informed our inductive, iterative approach to analysis.
RESULTS
Eight themes were identified, characterizing the complexity of these patients' lived experiences: major categories of side effects experienced and how they impacted patient well-being; the heterogeneous nature of side effects experienced; living with uncertainty; reframing the meaning and severity of SEs; focus on survival, hope, and being positive; acceptance and adaptation; feeling supported; and faith in medical innovation. Throughout their accounts, participants highlighted the profound impact that immune checkpoint modulators had on their daily lives.
CONCLUSION
This is the first in-depth qualitative study into patient accounts of their experiences of treatment with immune checkpoint modulators, related side effects, and how it impacted their daily lives. This research is an integral initial step in developing an instrument that will assess treatment-related side effects in patients treated with this form of therapy.

Identifiants

pubmed: 32119767
doi: 10.1002/cam4.2940
pmc: PMC7196048
doi:

Substances chimiques

Immune Checkpoint Inhibitors 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3015-3022

Informations de copyright

© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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Auteurs

Kari Ala-Leppilampi (K)

Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.

Natalie A Baker (NA)

Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.

Chris McKillop (C)

Turalt, Inc, Toronto, Canada.

Marcus O Butler (MO)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Lillian L Siu (LL)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Anna Spreafico (A)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Albiruni R Abdul Razak (AR)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Anthony M Joshua (AM)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.
Department of Medical Oncology, Kinghorn Cancer Centre, St Vincents Hospital and Garvan Institute of Medical Research, Sydney, Australia.

David Hogg (D)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Philippe L Bedard (PL)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Natasha Leighl (N)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Amit M Oza (AM)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

Janet A Parsons (JA)

Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.
Department of Physical Therapy and the Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.

Aaron R Hansen (AR)

Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada.

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