Do informed patients have different CIPN outcomes? Results of a Research Advocacy Network survey.

Abstract

60 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is common in cancer patients (pts). CIPN impacts quality of life (QoL) and causes emotional distress and treatment (Tx) delays. No agents are recommended for prevention and one agent is recommended for Tx of CIPN (ASCO Guidelines, 2014). Limited data exist about pt experiences with CIPN. The study goal was to understand pt experiences related to CIPN. Methods: An online, 67-question survey was completed by pts with breast or lung cancer. All had chemotherapy and self-reported moderate (mod) or severe CIPN within the past 2 years (mild CIPN excluded). Pts rated CIPN symptom frequency, socioemotional wellness, and impact on a 6- or 7-point scale (depending on item) and bothersomeness on a 5-point scale. Results were not analyzed by chemotherapy type. Results: Respondents had early breast cancer (EBC; n = 114), metastatic breast cancer (MBC; n = 96), or lung cancer (LC, all stages; n = 65). All EBC and MBC and 72% of LC pts were women; > 80% were White. Moderate CIPN existed in 63%, 67%, and 82% of EBC, MBC, and LC pts; severe CIPN occurred in 37%, 33%, and 18%, respectively. CIPN severity was associated with reduced QoL. Very/extremely bothersome effects on QoL occurred in 63% severe CIPN (n = 86) and 15% mod CIPN (n = 189) pts. Almost all EBC (94%) and two-thirds of MBC and LC pts had persistent CIPN. Symptoms included foot (97%)/hand (88%) numbness/tingling, foot (92%)/hand (81%) discomfort, foot/leg pain (85%), and joint pain (83%). Pts reported reduced physical function, productivity, and socioemotional wellness. Receiving information before Tx was linked with greater chance of mod vs severe CIPN. More pts with mod vs severe CIPN (37% vs 21%) received information about CIPN before chemotherapy. Having healthcare providers (HCPs) ask about symptoms was linked with a greater chance of mod vs severe CIPN. More pts with mod vs severe CIPN (28% vs 17%) had HCPs ask about CIPN symptoms. Conclusions: Learning about CIPN before chemotherapy was associated with a lower chance of severe CIPN. Early and ongoing communication with pts about risks, manifestations, and importance of reporting CIPN may limit severe CIPN and preserve QoL specifically with regards to socioemotional wellness.