Discussing treatment (Tx) and clinical trials for pancreatic cancer (PC): Learnings from the Pancreatic Cancer Action Network (PanCAN) survey.

Abstract

241 Background: In 2014, 46,420 patients (pts) in the US will be diagnosed with PC, and only 6.7% are expected to survive ≥ 5 years after diagnosis. Enrollment in clinical trials is recommended to improve pt outcomes. Methods: Funded by Celgene, PanCAN developed a 25-minute survey and distributed it online between 7/30/13 and 9/18/13 to pts with PC or caregivers whose loved ones were alive or had died of PC within the past 6 months. Results: Respondents included 184 pts (81 with metastatic PC) and 213 caregivers (145 for pts with metastatic PC). Pts and caregivers answered similarly with a few exceptions. Quality of life (QoL), extending survival, and symptom management were the 3 most important issues to all respondents. Caregivers placed statistically significantly more emphasis on QoL and managing symptoms vs pts (88% vs 71% and 68% vs 33%, respectively). A total of 196 respondents reported that Tx options were not offered at diagnosis, and 20% of these respondents stated that Tx options were never discussed with an MD. Most pts (95%) followed their doctors’ Tx recommendation, and 83% received chemotherapy. Almost half of respondents (49%) reported that their MD never discussed clinical trials; of those that did, oncologists (52%) were the primary source used to learn about possible clinical trial participation, followed by caregivers (16%) and loved ones (13%).Twelve percent of pts enrolled in clinical trials (> the US average of 4.6%; J Clin Oncol 31:3432-3438). Forty-eight percent of respondents were aware of the Pt and Liaison Services (PALS) program, a support service from PanCAN. PALS-aware respondents were more likely than others to report that the pt had undergone chemotherapy (89% vs 78%), surgery (64% vs 41%), or radiation (47% vs 32%) and more likely to state that the pt followed a Tx recommendation because it was the best/most realistic option (19% vs 11%). PALS-aware pts also participated more often in clinical trials (15% vs 9%). Conclusions: These results underscore the importance of discussing Tx options, clinical trials, and support services with pts. Such steps could increase Tx and enrollment in clinical trials, possibly improving QoL, survival, and symptom management.