Coping strategies and patient-reported outcomes (PROs) in early-phase cancer clinical trial (EP-CT) participants.

Abstract

e23194 Background: Individuals with cancer often rely on various coping strategies as they navigate their cancer course. Little is known about coping strategies among patients enrolled on EP-CTs or associations of these coping strategies with other PROs. Methods: We prospectively enrolled adults with cancer participating in EP-CTs at Massachusetts General Hospital from 4/2021-1/2023. Participants completed baseline surveys prior to EP-CT initiation that assessed coping strategies (Brief COPE), quality of life (QOL; Functional Assessment of Cancer Therapy-General), hope (Herth Hope Index), depression/anxiety symptoms (Patient Health Questionnaire-4), and financial wellbeing (COST tool). We used regression models to explore associations of coping strategies with patient characteristics and PROs (QOL, hope, depression/anxiety symptoms, financial wellbeing). Results: Among 205 participants (median age = 63.3 [range: 31.8-88.6], 57% female), the most common cancer types were gastrointestinal (35%) and breast (20%). Patients in this cohort utilized the following coping strategies (range 0-6): acceptance (mean = 4.81), emotional support (mean = 4.63), active (mean = 4.30), positive reframing (mean = 3.13), religion (mean = 2.77), self-blame (mean = .87), denial (mean = .59), and behavioral disengagement (mean = .36). Older age was associated with decreased use of self-blame coping (B = -0.02, p = .025). Female sex was associated with higher scores for denial (B = 0.42, p = .009), emotional support (B = 0.50, p = .037), positive reframing (B = 0.57, p = .036), and religion (B = 1.02, p = .001) coping compared with males. See table for associations of coping strategies with PROs (QOL, hope, depression/anxiety symptoms, financial wellbeing). Conclusions: In this cohort of EP-CT participants, we demonstrated that patients use multiple coping strategies and identified differences by age and sex. Notably, we found that some coping behaviors (acceptance, emotional support, positive reframing) were more favorably associated with QOL, hope, depression/anxiety symptoms, and financial wellbeing than others (denial, self-blame, behavioral disengagement). Interventions seeking to enhance PROs in this population should address patients’ use of coping strategies. [Table: see text]