QOL-20. INCLUDING BRAIN METASTASES PATIENTS IN PSYCHOLOGICAL INTERVENTIONS: A PHASE II SINGLE-ARM INVESTIGATION OF MANAGING CANCER AND LIVING MEANINGFULLY

Abstract

Abstract BACKGROUND Patients with brain cancer demonstrate substantial psychological distress yet are frequently excluded from psychological research. Managing Cancer and Living Meaningfully (CALM), an expressive-supportive psychotherapy designed to address the challenges faced by patients with advanced cancer. CALM is proven to reduce depression and death-related distress; however, patients with brain metastases (bMETs) have not been formally examined for CALM’s appropriateness or effectiveness. METHODS In this ongoing Phase II trial, 15 adults with bMETs and heightened distress (PHQ/DADDS) participate in a six-session CALM intervention and complete intervention satisfaction surveys and interviews. Data collection includes established feasibility and acceptability metrics, intervention satisfaction surveys and interviews, and changes in distress patient reported outcomes (pre-to-post CALM). RESULTS Of 21 patients screened, 15 enrolled in the study (73% female; 80% White; Mage = 58yrs). All 15 bMET participants completed baseline assessments, with 13 trial initiators, and 2 screen fails. To date, 8 participants have completed treatment. Reasons for withdrawal include disinterest in intervention topics (n = 1) and lost to follow-up (n = 2). Retention is 73%, with 2 participants still in active treatment. No adverse events were determined to be study-related. Perceived benefit was high (4.3/5), and all participants reported they would recommend the program to others. Reductions in depression severity were demonstrated in 6 of 8 completed participants (MPHQ Reduction = 7.6, range = 2-11) and in death anxiety severity for 7 of 8 completed participants (MDADDS-F1 Reduction = 14.7, range = 6-23). CONCLUSIONS Preliminary data suggests that CALM is both feasible and acceptable among adult patients with bMETs. Enrollment and retention rates are adequate. Patients report high benefit and recommendation to others. Overall, depression and death-related distress severity scores improved, suggesting CALM may be a promising intervention for neuro-oncology patients as they navigate the challenges of metastatic brain cancer. These findings support advancement to the next stage, a Phase II pilot RCT.