Presentation on theme: "Oncologists Views about the Treatments and Care Associated with Advanced varian Cancer Jenkins V 1, Banerjee S 2, Ledermann J 3, Gore M 2, Catt S 1, Monson."— Presentation transcript:
Oncologists Views about the Treatments and Care Associated with Advanced varian Cancer Jenkins V 1, Banerjee S 2, Ledermann J 3, Gore M 2, Catt S 1, Monson K 1, Fallowfield L 1 1 SHORE-C University of Sussex, 2 The Royal Marsden NHS Foundation Trust London, 3 University College London Background The management of ovarian cancer (OC) involves a multidisciplinary approach and depends on factors including histological subtype, grade, stage of the cancer and performance status. Treatment is essentially palliative and aims to reduce the symptoms of disease without creating too many extra burdens and iatrogenic harms. Surgery together with 1 st & 2 nd line chemotherapy is standard practice, but there are few published data on the variations in practice across the UK. Method Online survey between October & December 2011 to canvass opinions from UK oncologists about their management of women with advanced OC. This survey was carried out prior to the Cancer Drugs Fund decision about bevacizumab. The survey has 5 sections:- 1.Demographics: plus perceptions of most troubling presenting symptoms for OC 2.Routine NHS care (Non Trial Patients): 1 st, 2 nd line treatments & subsequent therapies 3.Maintenance therapy: plus opinions about minimum gain required for PFS and OS 4.Clinical trial participation 5.Supportive care Additionally, we are interviewing 200 patients about their experiences of treatment and management of their disease in the ADV CATE study (Advanced Ovarian Cancer: Care & Treatment Experiences). See Poster # B142 Acknowledgement: Roche UK unrestricted educational grant. Section 2: Routine NHS care (non-trial) 63/65 (97%) conducted regular follow up clinics 43/66 (65%) measured routine CA125 blood levels Which agents do you most commonly use in routine NHS care? carboplatin with paclitaxel 56/66 (85%) Results: Section 1: Demographics N (66) Sex male/female33/33 medical/clinical oncologist44/22 NHS Trust clinician/University clinical academic54/11 NHS alone/NHS & Private36/30 number of advanced OC patients treated per year? <30 31-60 >60 14 27 25 Section 3: Maintenance therapy If available would you offer maintenance therapy based on:- Progression Free Survival (PFS): 50/60 (83%)Yes Overall Survival (OS): 60/60 (100%) Yes Question Months 1-23-45-67+ What minimum gain in PFS would make YOU feel it worthwhile to offer maintenance therapy? (n=50) 019247 What do you think YOUR PATIENT would consider worthwhile? (n=50) 122693 What minimum gain in OS would make YOU feel it worthwhile to offer maintenance therapy? (n=60) 236157 What do you think YOUR PATIENT would consider worthwhile? (n=60) 252357 Section 4: Clinical trial participation 59/60 (98%) clinicians active in clinical trials 21/59 (36%) conduct early phase trials 29/32 (91%) refer 1-4 patients per year for early phase trials Summary: Treatment for OC across UK varies and main triggers for change in management are also inconsistent Not all routinely measure CA125 at follow up Doctors perceptions of benefits they think worthwhile differ from those they believe their patients hold Supportive interventions for worst symptoms of disease and treatment side effects are needed Rank Order Main triggers for change in management of 1 st line treatment % 1 st symptomatic disease progression74% 2 nd severe side effects of current treatment41% 3 rd deterioration in quality of life46% 4 th non-symptomatic disease progression shown by test results 49% Rank ordered as 1 st choice in 2 nd line & subsequent treatments for patients who are:- % platinum sensitivecarboplatin + paclitaxel63% partially platinum sensitive carboplatin with paclitaxel 3 weekly 40% platinum resistantliposomal doxorubicin68% Section 5: Supportive care : Most recommended support/information sources PersonnelCNS (98%) cancer info centre (93%) dietician (87%) WrittenMacmillan (100%) In house leaflets (73%) Ovacome (28%) WebsitesMacmillan (91%) Ovacome (43%) Cancer help (42%)
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