1976P - Financial difficulties experienced by gastrointestinal stromal tumor (GIST) patients in the Netherlands: Data from a cross-sectional multicenter study

Background

Financial difficulties get little attention in daily clinical practice, while they can have a considerable impact on treatment outcomes and the patient’s quality of life. This study aims to explore the prevalence of financial difficulties among GIST patients, with a distinction in patients on tyrosine kinase inhibitor (TKI) treatment or not on TKI treatment, and investigate associations between financial difficulties and sociodemographic and clinical characteristics, work, cancer-related concerns, anxiety and depression.

Methods

A cross-sectional study was conducted among Dutch GIST patients between September 2020 and June 2021. Patients completed nine items regarding financial difficulties of the EORTC item bank, work-related questions, Hospital Anxiety and Depression Scale (HADS), Cancer Worry Scale (CWS) and EORTC QLQ-C30.

Results

In total, 328 GIST patients participated (response rate 63.0%), of which 108 (32.9%) were on TKI treatment. Experiencing financial difficulties was associated with significantly lower global quality of life (67.8 vs 81.6, p=<0.001) as compared to patients who did not report financial difficulties. Patients with financial difficulties also more frequently reported symptoms of anxiety (41.7% vs 11.5%, p=<0.001) and depression (36.1% vs 10.1%, p=<0.001), had more fear of cancer recurrence or progression (73.0% vs 39.9%, p=<0.001), and were more often concerned about dying from GIST both in the near future (64.9% vs 34.9%, p=<0.001) and in the long run (75.7% vs 49.5%, p=0.003). The odds of experiencing financial difficulties was 16.4 (95% CI 1.24-217.1; p=0.03) times higher in patients that were less able to work. Patients currently treated with TKIs experienced significantly more financial difficulties compared to patients not on TKIs (17.6% vs 8.7%, p=0.02).

Conclusions

Even in a country where the costs of TKIs and follow-up care are covered by health insurance, financial difficulties can be present in GIST patients, especially in patients on TKI treatment. Given the association between financial difficulties with quality of life, anxiety, depression and cancer-related concerns, more support should be provided to patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The survey 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.