OpenLB
Open Library of Bioscience
Advanced Search
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Dec 27, 2022;31 (1): 82.

Impact of early palliative care on additional line of chemotherapy in metastatic breast cancer patients: results from the randomized study OSS.

Gisèle Chvetzoff, Carole Bouleuc, Audrey Lardy-Cléaud, Pierre Saltel, Véronique Dieras, Magali Morelle, Jean-Paul Guastalla, Olivier Tredan, Paul Rebattu, Simona Pop, Isabelle Ray-Coquard, Jean-Yves Pierga, Laurent Mignot, Valérie Laurence, Valérie Bourne-Branchu, David Pérol, Thomas Bachelot
Author Information
  1. Gisèle Chvetzoff: Supportive Care Department, Centre Léon Bérard, 28 rue Laennec, 69373, Lyon, France. gisele.chvetzoff@lyon.unicancer.fr.
  2. Carole Bouleuc: Supportive Care Department, Institut Curie, Paris, France.
  3. Audrey Lardy-Cléaud: Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France.
  4. Pierre Saltel: Supportive Care Department, Centre Léon Bérard, 28 rue Laennec, 69373, Lyon, France.
  5. Véronique Dieras: Medical Oncology Department, Institut Curie, Paris, France.
  6. Magali Morelle: Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France.
  7. Jean-Paul Guastalla: Medical Oncology Department, Centre Léon Bérard, Lyon, France.
  8. Olivier Tredan: Medical Oncology Department, Centre Léon Bérard, Lyon, France.
  9. Paul Rebattu: Medical Oncology Department, Centre Léon Bérard, Lyon, France.
  10. Simona Pop: Medical Oncology Department, Institut Curie, Paris, France.
  11. Isabelle Ray-Coquard: University Claude Bernard, Lyon, France.
  12. Jean-Yves Pierga: Medical Oncology Department, Institut Curie, Paris, France.
  13. Laurent Mignot: Medical Oncology Department, Institut Curie, Paris, France.
  14. Valérie Laurence: Medical Oncology Department, Institut Curie, Paris, France.
  15. Valérie Bourne-Branchu: Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France.
  16. David Pérol: Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France.
  17. Thomas Bachelot: Medical Oncology Department, Centre Léon Bérard, Lyon, France.
PMID: 36574052 DOI: 10.1007/s00520-022-07561-x

Abstract

PURPOSE: The most appropriate criteria and timing for palliative care referral remain a critical issue, especially in patients with metastatic breast cancer for whom long-term chemosensibility and survival are observed. We aimed to compare the impact of early palliative care including formal concertation with oncologists on decision for an additional line of chemotherapy compared with usual oncology care.
METHODS: This randomized prospective study enrolled adult women with metastatic breast cancer and visceral metastases with a 3rd- or 4th-line chemotherapy (CT). patients received usual oncology care with a palliative care consultation only upon patient or oncologist request (standard group, S) or were referred to systematic palliative care consultation including a regular concertation between palliative care team and oncologists (early palliative care group, EPC). The primary endpoint was the rate of an additional CT (4th or 5th line) decision. Quality of life, symptoms, social support and satisfaction were self-evaluated at 6 and 12 months, at treatment discontinuation or 3 months after discontinuation.
RESULTS: From January 2009 to November 2012, two authorized cancer centers included 98 women (EPC: 50; S: 48). Thirty-seven (77.1%, 95%CI 62.7-88%) patients in the EPC group had a subsequent chemotherapy prescribed and 36 (72.0%, 95%CI 57.5-83.8%) in the S group (p = 0.646). No differences in symptom control and global quality of life were observed, but less deterioration in physical functioning was reported in EPC (EPC: 0 [- 53-40]; S: - 6; 7 [- 60 to - 20]; p = 0.027). Information exchange and communication were significant improved in EPC (exchange, EPC: - 8.3 [- 30 to + 7]; S: 0.0 [- 17 to + 23]; p = 0.024; communication, EPC: 12.5 [- 8 to - 37]; S: 0.0 [- 21 to + 17]; p = 0.004).
CONCLUSION: EPC in metastatic breast cancer patients did not impact the prescription rate of additional chemotherapy in patients a 3rd- or 4th-line chemotherapy for metastatic breast cancer; however, EPC may contribute to alleviate deterioration in physical functioning, while facilitating communication.
TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT00905281, May 20, 2009.

Keywords

Advanced breast cancer Chemotherapy Early palliative care Supportive care

Associated Data

ClinicalTrials.gov | NCT00905281

References

  1. Molinié F, Tretarre B, Arveux P, Woronoff AM, Lecoffre C, Lafay L, et al. (2020) Survie des personnes atteintes de cancer en France métropolitaine 1989 2018. https://www.e-cancerfr 2020.
  2. Siegel RL, Miller KD, Fuchs HE, Jemal A (2021) Cancer Statistics CA: A Cancer Journal for Clinicians 71:7–33 [DOI: 10.3322/caac.21654]
  3. DeSantis CE, Ma J, Gaudet MM, Newman LA, Miller KD, Goding Sauer A et al (2019) Breast cancer statistics 2019. Cancer J Clin 69:438–51 [DOI: 10.3322/caac.21583]
  4. Dufresne A, Pivot X, Tournigand C, Facchini T, Altweegg T, Chaigneau L et al (2008) Impact of chemotherapy beyond the first line in patients with metastatic breast cancer. Breast Cancer Res Treat 107:275–9. https://doi.org/10.1007/s10549-007-9550-7 [DOI: 10.1007/s10549-007-9550-7]
  5. Edman Kessler L, Sigfridsson J, Hatzidaki D, Bergh J, Foukakis T, Georgoulias V et al (2020) Chemotherapy use near the end-of-life in patients with metastatic breast cancer. Breast Cancer Res Treat 181:645–51. https://doi.org/10.1007/s10549-020-05663-w [DOI: 10.1007/s10549-020-05663-w]
  6. Mathew A, Achkar T, Abberbock S, Sandhu GS, Jacob ME, Das Villgran V et al (2017) (2017) Prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer. Breast J 23:718–22. https://doi.org/10.1111/tbj.12905 [DOI: 10.1111/tbj.12905]
  7. Shin JA, Parkes A, El-Jawahri A, Traeger L, Knight H, Gallagher ER et al (2016) Retrospective evaluation of palliative care and hospice utilization in hospitalized patients with metastatic breast cancer. Palliat Med 30:854–61. https://doi.org/10.1177/0269216316637238 [DOI: 10.1177/0269216316637238]
  8. Chen Y, Lin S, Zhu Y, Xu R, Lan X, Xiang F et al (2020) Prevalence, trend and disparities of palliative care utilization among hospitalized metastatic breast cancer patients who received critical care therapies. The Breast 54:264–71. https://doi.org/10.1016/j.breast.2020.11.001 [DOI: 10.1016/j.breast.2020.11.001]
  9. Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 35:96–112. https://doi.org/10.1200/JCO.2016.70.1474 [DOI: 10.1200/JCO.2016.70.1474]
  10. Jordan K, Aapro M, Kaasa S, Ripamonti CI, Scotté F, Strasser F et al (2018) European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol 29:36–43. https://doi.org/10.1093/annonc/mdx757 [DOI: 10.1093/annonc/mdx757]
  11. Zimmermann C, Swami N, Krzyzanowska M, Hannon B, Leighl N, Oza A et al (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. The Lancet 383:1721–30. https://doi.org/10.1016/S0140-6736(13)62416-2 [DOI: 10.1016/S0140-6736(13)62416-2]
  12. Lu Z, Fang Y, Liu C, Zhang X, Xin X, He Y et al (2021) Early interdisciplinary supportive care in patients with previously untreated metastatic esophagogastric cancer: a phase iii randomized controlled trial. J Clin Oncol 39:748–56. https://doi.org/10.1200/JCO.20.01254 [DOI: 10.1200/JCO.20.01254]
  13. Temel JS, Greer JA, Admane S, Gallagher ER, Jackson VA, Lynch TJ et al (2011) Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non–small-cell lung cancer: results of a randomized study of early palliative care. J Clin Oncol 29:2319–26. https://doi.org/10.1200/JCO.2010.32.4459 [DOI: 10.1200/JCO.2010.32.4459]
  14. Greer JA, Pirl WF, Jackson VA, Muzikansky A, Lennes IT, Heist RS et al (2012) Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non–small-cell lung cancer. J Clin Oncol 30:394–400. https://doi.org/10.1200/JCO.2011.35.7996 [DOI: 10.1200/JCO.2011.35.7996]
  15. Earle CC, Landrum MB, Souza JM, Neville BA, Weeks JC, Ayanian JZ (2008) Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol 26:3860–6. https://doi.org/10.1200/JCO.2007.15.8253 [DOI: 10.1200/JCO.2007.15.8253]
  16. Haun MW, Estel S, Rücker G, Friederich H-C, Villalobos M, Thomas M, et al. (2017) Early palliative care for adults with advanced cancer. Cochrane Database of Systematic Reviews 2017;. https://doi.org/10.1002/14651858.CD011129.pub2 .
  17. Kavalieratos D, Corbelli J, Zhang D, Dionne-Odom JN, Ernecoff NC, Hanmer J et al (2016) Association between palliative care and patient and caregiver outcomes. JAMA 316:2104. https://doi.org/10.1001/jama.2016.16840 [DOI: 10.1001/jama.2016.16840]
  18. Jäger EM, Filipits M, Glechner A, Zwickl-Traxler E, Schmoranzer G, Pecherstorfer M et al (2020) Retrospective analysis of the prevalence of specialised palliative care services for patients with metastatic breast cancer. ESMO Open 5:e000905. https://doi.org/10.1136/esmoopen-2020-000905 [DOI: 10.1136/esmoopen-2020-000905]
  19. Rabow M, Small R, Jow A, Majure M, Chien A, Melisko M et al (2018) The value of embedding: integrated palliative care for patients with metastatic breast cancer. Breast Cancer Res Treat 167:703–8. https://doi.org/10.1007/s10549-017-4556-2 [DOI: 10.1007/s10549-017-4556-2]
  20. Bakitas MA, Tosteson TD, Li Z, Lyons KD, Hull JG, Li Z et al (2015) Early versus delayed initiation of concurrent palliative oncology care: patient outcomes in the ENABLE III randomized controlled trial. J Clin Oncol 33:1438–45. https://doi.org/10.1200/JCO.2014.58.6362 [DOI: 10.1200/JCO.2014.58.6362]
  21. McLachlan S-A, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M et al (2001) Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 19:4117–25. https://doi.org/10.1200/JCO.2001.19.21.4117 [DOI: 10.1200/JCO.2001.19.21.4117]
  22. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–76. https://doi.org/10.1093/jnci/85.5.365 [DOI: 10.1093/jnci/85.5.365]
  23. Cousson-Gélie F, Irachabal S, Bruchon-Schweitzer M, Dilhuydy JM, Lakdja F (2005) Dimensions of cancer locus of control scale as predictors of psychological adjustment and survival in breast cancer patients. Psychol Rep 97:699–711. https://doi.org/10.2466/pr0.97.3.699-711 [DOI: 10.2466/pr0.97.3.699-711]
  24. Bolognini M, Bettschart W, Zehnder-Gubler M, Rossier L (1989) The validity of the French version of the GHQ-28 and PSYDIS in a community sample of 20 year olds in Switzerland. Eur Arch Psychiatry Neurol Sci 238:161–8. https://doi.org/10.1007/BF00451005 [DOI: 10.1007/BF00451005]
  25. Barlési F, Chabert-Greillier L, Loundou A, Siméoni M-C, Greillier L, Doddoli C et al (2006) Validation de la version française du Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH/PSQ-MD): le F-PMH/PSQ-MD. Revue Des Maladies Respir 23:227–36. https://doi.org/10.1016/S0761-8425(06)71572-8 [DOI: 10.1016/S0761-8425(06)71572-8]
  26. Greer JA, Moy B, El-Jawahri A, Jackson VA, Kamdar M, Jacobsen J et al (2022) Randomized trial of a palliative care intervention to improve end-of-life care discussions in patients with metastatic breast cancer. J Natl Compr Cancer Network 20:136–43. https://doi.org/10.6004/jnccn.2021.7040 [DOI: 10.6004/jnccn.2021.7040]
  27. Janah A, Gauthier LR, Morin L, Bousquet PJ, le Bihan-Benjamin C, Tuppin P et al (2019) Access to palliative care for cancer patients between diagnosis and death: a national cohort study. Clin Epidemiol 11:443–55. https://doi.org/10.2147/CLEP.S198499 [DOI: 10.2147/CLEP.S198499]
  28. Smith TJ, Temin S, Alesi ER, Abernethy AP, Balboni TA, Basch EM et al (2012) American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care Into Standard Oncology Care. J Clin Oncol 30:880–7. https://doi.org/10.1200/JCO.2011.38.5161 [DOI: 10.1200/JCO.2011.38.5161]
  29. Rochigneux P, Raoul JL, Beaussant Y, Aubry R, Goldwasser F, Tournigand C et al (2017) Use of chemotherapy near the end of life: what factors matter? Ann Oncol 28:809–17. https://doi.org/10.1093/annonc/mdw654 [DOI: 10.1093/annonc/mdw654]
  30. Gilligan T, Coyle N, Frankel RM, Berry DL, Bohlke K, Epstein RM et al (2017) Patient-clinician communication: American Society of Clinical Oncology Consensus Guideline. J Clin Oncol 35:3618–32. https://doi.org/10.1200/JCO.2017.75.2311 [DOI: 10.1200/JCO.2017.75.2311]
  31. Chosich B, Burgess M, Earnest A, Franco M, Runacres F, William L et al (2020) Cancer patients’ perceptions of palliative care. Support Care Cancer 28:1207–14. https://doi.org/10.1007/s00520-019-04917-8 [DOI: 10.1007/s00520-019-04917-8]
  32. Fox JA, Rosenberg J, Ekberg S, Langbecker D (2020) Palliative care in the context of immune and targeted therapies: a qualitative study of bereaved carers’ experiences in metastatic melanoma. Palliat Med 34:1351–60. https://doi.org/10.1177/0269216320916154 [DOI: 10.1177/0269216320916154]
  33. LeBlanc TW (2020) Hoping for the best and preparing for the worst: a forgotten maxim in the immunotherapy era? Palliat Med 34:1289–90. https://doi.org/10.1177/0269216320954621 [DOI: 10.1177/0269216320954621]
  34. Hui D, Mori M, Watanabe SM, Caraceni A, Strasser F, Saarto T et al (2016) Referral criteria for outpatient specialty palliative cancer care: an international consensus. Lancet Oncol 17:e552-9. https://doi.org/10.1016/S1470-2045(16)30577-0 [DOI: 10.1016/S1470-2045(16)30577-0]
  35. Molin Y, Gallay C, Gautier J, Lardy-Cleaud A, Mayet R, Grach M et al (2019) PALLIA-10, a screening tool to identify patients needing palliative care referral in comprehensive cancer centers: a prospective multicentric study (PREPA-10). Cancer Med 8:2950–61. https://doi.org/10.1002/cam4.2118 [DOI: 10.1002/cam4.2118]

MeSH Term

Adult
Humans
Female
Palliative Care
Breast Neoplasms
Quality of Life
Prospective Studies
Hospice and Palliative Care Nursing
Neoplasms
Randomized Controlled Trial Journal Article
Article has an altmetric score of 6

Word Cloud

Created with Highcharts 10.0.0care0palliativecancerbreastchemotherapyEPC[-metastaticpatientsadditionalgroupEPC:S:p=-earlylinecommunication+observedimpactincludingconcertationoncologistsdecisionusualoncologyrandomizedstudywomen3rd-4th-lineCTconsultationSratelife612monthsdiscontinuation3200995%CIdeteriorationphysicalfunctioningexchange8PURPOSE:appropriatecriteriatimingreferralremaincriticalissueespeciallylong-termchemosensibilitysurvivalaimedcompareformalcomparedMETHODS:prospectiveenrolledadultvisceralmetastasesPatientsreceiveduponpatientoncologistrequeststandardreferredsystematicregularteamprimaryendpoint4th5thQualitysymptomssocialsupportsatisfactionself-evaluatedtreatmentRESULTS:JanuaryNovember2012twoauthorizedcentersincluded985048Thirty-seven771%627-88%subsequentprescribed36720%575-838%646differencessymptomcontrolglobalqualitylessreported53-40]76020]027Informationsignificantimproved307]1723]024537]2117]004CONCLUSION:prescriptionhowevermaycontributealleviatefacilitatingTRIALREGISTRATION:ClinicalTrialgovidentifier:NCT00905281May20Impactpatients:resultsOSSAdvancedChemotherapyEarlySupportive

Similar Articles

Cited By (1)