Patient Understanding of Precision Oncology, QOL Implications Continues to Increase

In the era of precision medicine in oncology, recent years have seen a slew of research on the clinical impact that these treatments have on responses and survival; however, as patients live longer from these types of treatments, some research has also looked at how much patients understand this new frontier of cancer treatment, how they feel about it, and how their quality of life (QOL) is impacted.

More and more, clinical trials of cancer therapies are including outcomes focused on the perspective of the patient, often referred to as patient-reported outcomes. However, published data on these outcomes are limited.

“When examining QOL, it is essential to look at patient health outcomes and global health status,” wrote the authors of a review on the topic published in Future Oncology. “Developing and implementing this strategy relies on collaboration between patients, patient organizations, healthcare professionals and industry. Patient health outcomes should be measured using the results that matter most to patients: recovery, functional improvement, physical functioning, emotional well-being and the ability to perform activities of daily living.”

Across the published literature that exists, the QOL impact varies, explained the researchers:

• Among patients with metastatic colorectal cancer, pembrolizumab yielded clinically meaningful improvements in both patient health outcomes and global health status and the time to QOL deterioration was prolonged.
• In patients receiving entrectinib for solid tumors with NTRK or ROS1 mutations, overall QOL scores did not improve from baseline.
• For patients receiving larotrectinib for TRK fusion cancers, QOL improved within 2 months of treatment and was sustained for 68% of adults and 71% of children.

A greater understanding of precision oncology has also occurred among patients, according to the authors, who explained that in 2012, less than 50% of surveyed patients knew what “precision oncology” meant. At that time, many also reported concerns with genomic testing of their tumors.

Just a few years later, in 2016, a multinational survey showed that 78% of patients reported understanding that they could receive genetic testing of their tumor to determine which treatment was most appropriate for them.

The researchers also stressed the importance of the relationship between the patient and their provider, arguing that in order to have successful decision-making, there needs to be shared trust between the two. They explained, “physicians are at the interface between research and real-world medicine, and physician trustworthiness is instrumental in influencing and promoting such programs.”

Reference

Lassen U, Makaross L, Stenzinger A, et al. Precision oncology: a clinical and patient perspective. Future Oncol. Published online July 19, 2021. doi:10.2217/fon-2021-0688