1915MO - Fear, anxiety and depression in gastrointestinal stromal tumor (GIST) patients in the Netherlands: Data from a cross-sectional multicenter study

Background

The introduction of tyrosine kinase inhibitors (TKIs) has led to a phenomenal progress in the treatment of gastrointestinal stromal tumors (GIST). Prolonging the survival of GIST patients may also entail more psychological and emotional distress. This study aims to investigate (1) the prevalence of anxiety, depression and fear of cancer recurrence or progression (FCR) in GIST patients on TKI treatment or not on TKI treatment, (2) factors associated with anxiety, depression and severe FCR, and (3) the relationship between anxiety, depression, severe FCR and global quality of life.

Methods

In a cross-sectional population-based survey study, Dutch GIST patients completed self-report questionnaires including the Hospital Anxiety and Depression Scale (HADS), Cancer Worry Scale (CWS) and the EORTC QLQ-C30.

Results

A total of 328 (response rate 63%) patients responded, 108 (32.9%) of whom received TKI treatment at time of the questionnaire. Patients on TKI treatment had a significantly higher prevalence of symptoms of depression (21.5% vs 8.7%, p=0.001) and severe FCR (59.3% vs 35.4%, p=<0.001) compared to those not on TKI treatment, while anxiety did not differ between the groups (18.7% vs 13.0%). Patients on TKI treatment had 2.3 (95% CI 1.1-4.9; p=0.025) and 2.7 (95% CI 1.6-4.5; p=<0.001) higher odds of experiencing symptoms of depression and severe FCR, respectively, than those not on TKI. Other factors associated with symptoms of depression and severe FCR were younger age at diagnosis and having more than two comorbidities. Global quality of life was significantly lower in patients who experienced symptoms of anxiety (64.9 vs 82.8, p=<0.001), depression (59.8 vs 83.2, p=<0.001) or severe FCR (73.2 vs 85.0, p=<0.001) as compared to patients who were not anxious, depressed or experienced severe FCR.

Conclusions

GIST patients on TKI treatment are more prone to experience symptoms of depression and severe FCR than those not on TKI treatment, which can significantly impair their global quality of life. Given the high prevalence of FCR and symptoms of depression, this deserves more attention in clinical practice and appropriate interventions should be provided.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The study was partly funded by a research grant from Novartis (grant no. 006.18).

Disclosure

H. Gelderblom: Financial Interests, Institutional, Local PI: Daiichi Sankyo, Deciphera, Novartis, Cytovation; Financial Interests, Institutional, Coordinating PI: Boehringer Ingelheim, AmMax Bio, Debiopharm. A.K.L. Reyners: Financial Interests, Institutional, Other, Member of the board: Dutch Society of Medical Oncology; Financial Interests, Institutional, Coordinating PI, FIRST study; coordinator for the Netherlands: Tesaro; Financial Interests, Institutional, Local PI, Local PI GCT1015-05 study: Genmab; Financial Interests, Institutional, Local PI, Local PI for the RUBY study: Tesaro; Financial Interests, Institutional, Local PI, Local PI of the R2810 study: Regeneron; Financial Interests, Institutional, Local PI, PI of MK3475-C93 trial: Merck; Non-Financial Interests, Leadership Role, Chairperson of the group that advises the Dutch Society of Medical Oncology whether EMA authorised medication should be common practice in the Netherlands (cieBOM).: Dutch Society of Medical Oncology. N. Steeghs: Financial Interests, Institutional, Advisory Board: Boehringer Ingelheim, Ellipses Pharma, Luszana; Financial Interests, Personal, Advisory Board: GSK, Incyte; Financial Interests, Institutional, Local PI: AbbVie, Actuate Therapeutics, Amgen, Array, Ascendis Pharma, AstraZeneca, Bayer, Blueprint Medicines, Boehringer Ingelheim, BridgeBio, BMS, Cantargia, CellCentric, Cogent Biosciences, Crescendo Biologics, Cytovation, Deciphera, Dragonfly, Eli Lilly, Exelixis, Genentech, GSK, IDRx, Immunocore, Incyte, InteRNA, Janssen, Kinnate Biopharma, Kling Biotherapeutics, Luszana, Merck, Merck Sharp & Dohme, Merus, Molecular Partners, Navire Pharma, Novartis, Numab Therapeutics, Pfizer, Relay Pharmaceuticals, Revolution Medicin, Roche, Sanofi, Seattle Genetics, Taiho, Takeda; Financial Interests, Institutional, Research Grant: AstraZeneca, Bayer, Deciphera, GSK, Lixte, Merck, Novartis, Pfizer, Roche. W.T.A. Van Der Graaf: Financial Interests, Institutional, Advisory Board: PTC Therapeutics, Agenus, SpringworksTx; Financial Interests, Institutional, Local PI, Clinical study: Springworks, Boehringer Ingelheim; Financial Interests, Institutional, Research Grant, IIS: Lilly; Financial Interests, Institutional, Local PI, Clinical Study: AYALA; Non-Financial Interests, Member of Board of Directors, President: EORTC; Non-Financial Interests, Member of Board of Directors: European Cancer Organisation; Non-Financial Interests, Member of Board of Directors, Chair: Dutch Sarcoma Group, Dutch AYA 'Young and Cancer' Care Network. All other authors have declared no conflicts of interest.