Priorities and preferences of advanced soft tissue sarcoma patients starting palliative chemotherapy: baseline results from the HOLISTIC study

E. Younger, R. L. Jones, D. den Hollander, V. L.M.N. Soomers, I. M.E. Desar, C. Benson, R. J. Young, A. W. Oosten, J. J. de Haan, A. Miah, S. Zaidi, H. Gelderblom, N. Steeghs, O. Husson*, W. T.A. van der Graaf

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Introduction: Palliative chemotherapy is the principal treatment of patients with advanced soft tissue sarcomas (STS); however prognosis is limited (median overall survival 12-19 months). In this setting, patient values and priorities are central to personalised treatment decisions. Patients and methods: The prospective HOLISTIC study was conducted in the UK and the Netherlands assessing health-related quality of life in STS patients receiving palliative chemotherapy. Participants completed a questionnaire before starting chemotherapy, including attitudes towards quality of life (QoL) versus length of life (LoL), decisional control preferences, and decisional conflict. Chi-square and Fisher's exact tests were used to evaluate associations between patient characteristics and preferences. Results: One hundred and thirty-seven patients with advanced STS participated (UK: n = 72, the Netherlands: n = 65). Median age was 62 (27-79) years. Preference for extended LoL (n = 66, 48%) was slightly more common than preference for QoL (n = 56, 41%); 12 patients (9%) valued LoL and QoL equally (missing: n = 3). Younger patients (age <40 years) prioritised LoL, whereas two-thirds of older patients (aged ≥65 years) felt that QoL was equally or more important than LoL (P = 0.020). Decisional conflict was most common in patients who prioritised QoL (P = 0.024). Most patients preferred an active (n = 45, 33%) or collaborative (n = 59, 44%) role in treatment decisions. Gender, performance status, and country were significantly associated with preferred role. Concordance between preferred and actual role in chemotherapy decision was high (n = 104, 76%). Conclusions: Heterogeneous priorities and preferences among advanced STS patients support personalised decisions about palliative treatment. Considering individual differences during treatment discussions may enhance communication and optimise patient-centred care.

Original languageEnglish
Article number100258
JournalESMO Open
Volume6
Issue number5
DOIs
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
We would like to thank all the patients who kindly participated in this study. The work was supported by The Royal Marsden NHS Foundation Trust together with The Institute of Cancer Research, which receives Biomedical Research Centre (BRC) funding through the National Institute for Health Research (NIHR). This work received financial support from Lilly (no grant number). RLJ is the recipient of grants/research support from Merck Sharp & Dohme, GlaxoSmithKline. RLJ is the recipient of consultation fees from Adaptimmune, Athenex, Blueprint, Clinigen, Eisai, Epizyme, Daichii, Deciphera, Immune Design, Lilly, Merck, Pharmamar, UptoDate. WvdG has received research grants from Novartis, has been on advisory board from Bayer and is consultant for SpringWorks. The other authors have declared no conflicts of interest. The data generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Funding Information:
The work was supported by The Royal Marsden NHS Foundation Trust together with The Institute of Cancer Research , which receives Biomedical Research Centre (BRC) funding through the National Institute for Health Research (NIHR). This work received financial support from Lilly (no grant number).

Funding Information:
RLJ is the recipient of grants/research support from Merck Sharp & Dohme, GlaxoSmithKline. RLJ is the recipient of consultation fees from Adaptimmune, Athenex, Blueprint, Clinigen, Eisai, Epizyme, Daichii, Deciphera, Immune Design, Lilly, Merck, Pharmamar, UptoDate. WvdG has received research grants from Novartis, has been on advisory board from Bayer and is consultant for SpringWorks. The other authors have declared no conflicts of interest.

Publisher Copyright:
© 2021 The Authors

Fingerprint

Dive into the research topics of 'Priorities and preferences of advanced soft tissue sarcoma patients starting palliative chemotherapy: baseline results from the HOLISTIC study'. Together they form a unique fingerprint.

Cite this