The impact of early palliative care on the quality of life of patients with advanced pancreatic cancer: The IMPERATIVE study.

Authors

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Stephanie Lelond

CancerCare Manitoba, Winnipeg, MB, Canada

Stephanie Lelond , Harvey Chochinov , Paul Joseph Daeninck , Benjamin Adam Goldenberg , Lisa Lix , Susan McClement , Christina Kim

Organizations

CancerCare Manitoba, Winnipeg, MB, Canada, University of Manitoba, Winnipeg, MB, Canada, Dept of Medical Oncology, CancerCare Manitoba, Winnipeg, MB, Canada, University of Manitoba, Manitoba Palliative Care Research Unit, Winnipeg, MB, Canada

Research Funding

Other Foundation
CancerCare Manitoba Foundation, Pharmaceutical/Biotech Company

Background: Pancreatic cancer is lethal. Chemotherapy can improve survival by months; however, many patients experience an overwhelming burden of cancer-associated symptoms and poor quality of life (QOL). Early palliative care (EPC) alongside standard oncologic care results in improved QOL and survival in patients with lung cancer. Although international guidelines recommend EPC for patients with advanced pancreatic cancer (PANC), the benefit is not known. Objectives: The primary objective is to test for change in QOL between baseline (BL) and 16 weeks (wk). Secondary objectives are to test for change between BL and 16 wk in (a) symptom control; and (b) depression and anxiety. Methods: This prospective case-crossover study of patients with PANC provides EPC plus standard oncologic care. Primary oncology clinics refer patients to an EPC team led by a palliative care physician and a clinical nurse specialist. BL questionnaires are completed prior to initial EPC assessment, then every 4 wk until wk 16. EPC visits are every 2 wk for the first month, every 4 wk until wk 16, and then as needed. QOL, symptom control, anxiety and depression are measured using the FACT-Hep tool, ESAS-r, HADS and PHQ-9, respectively. A generalized linear model will test for statistically significant change in scores between BL and 16 wk; chemotherapy (yes/no) is included as a confounding covariate; model fit will be assessed. A sample size of 20 patients provides 80% power after controlling for covariate effects. 40 patients will be enrolled to account for missing data. To date, 28 patients have enrolled and 17 have completed the intervention. Significance: The benefit of EPC for patients with PANC is not known, however, EPC is increasingly recognized internationally by patients and stakeholders as a critical intervention which may improve both QOL and satisfaction with care. The Canadian Partnership Against Cancer’s report on the patient experience states “the best possible patient experience means all people with cancer have equitable access to high-quality person-centered palliative care”. This study offers access to EPC and provides an environment in which the benefit of an integrated approach is evaluated.

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Abstract Details

Meeting

2020 Gastrointestinal Cancers Symposium

Session Type

Trials in Progress Poster Session

Session Title

Trials in Progress Poster Session B: Hepatobiliary Cancer, Neuroendocrine/Carcinoid, Pancreatic Cancer, and Small Bowel Cancer

Track

Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Pancreatic Cancer,Small Bowel Cancer

Sub Track

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 38, 2020 (suppl 4; abstr TPS777)

Abstract #

TPS777

Poster Bd #

P20

Abstract Disclosures

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