1886P - Expectations and priorities of older patients with cancer: The PRIORITY multicenter cohort study

Background

To assess treatment benefit in cancer trials for older patients, international societies suggest to account for patient-reported outcomes over solely tumour-centered ones. However, data on patients’ preferences are lacking. We aimed to identify expectations and priorities of older cancer patients.

Methods

We investigated expectations and priorities of patients with cancer considered for a first medical treatment in a palliative or curative intent in a multicenter prospective cohort. Two populations were included: aged 70 and above, between 18 and 69. Using self-completed questionnaires, patients as well as physicians had to prioritize 8 expectations at various timepoints (before treatment initiation, at 3, 6 and 12 months): treatment efficacy, life expectancy, autonomy, daily tasks, social activities, invasiveness of treatment, toxicity and economic burden.

Results

We included 233 older and 100 younger patients. In the older patient cohort, median age was 79 (70-96), with a majority of women (N=140, 66%) and breast and lung cancer represented 34% (N=78) and 12% (N=27) respectively. Treatment was initiated for metastatic setting in 45% of the patients. The most frequently rated top 1 priority was treatment efficacy at initiation in both older (73%) and younger cohorts (79%) followed by autonomy in the cohort of older patients (13%) and life expectancy in the cohort of younger patients (14%). Treatment efficacy was almost systematically cited in the top-4 priorities for both older (94%) and younger patients (96%), followed by autonomy (86%) for older patients and life expectancy for younger patients (82%). These expectations are also the most frequently stable priorities (>70%) between initiation and 3 months for each cohort. At treatment initiation, agreement rate for prioritization of expectations between older patients and their physicians (N=200 pairs) was 87% for treatment efficacy and 64% for autonomy. This agreement rate remained stable at 3 months (N=135 pairs).

Conclusions

While treatment efficacy was a common objective across all age categories, the second most cited priority was autonomy for older and life expectancy for younger patients. Many physicians failed to appropriately apprehend older patients expectations.

Clinical trial identification

NCT02821793.

Editorial acknowledgement

Legal entity responsible for the study

Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France.

Funding

Fondation Bordeaux Université.

Disclosure

T. Grellety: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer, Novartis, Lilly, Roche. M. Cabart: Financial Interests, Institutional, Local PI, AMPLITUDE Clinical Trial: Janssen; Other, Other, Travel fees, accommodations and registration for ASCO 2024: Daiichi Sankyo; Other, Other, Travel fees, accommodations and registration for ESMO 2022: Janssen. M. Chantecaille: Financial Interests, Personal, Invited Speaker: Astellas, Janssen Cillag; Non-Financial Interests, Personal, Advisory Role: Fresinius Kabi France. C. Terret: Financial Interests, Personal, Advisory Board: Lilly France. All other authors have declared no conflicts of interest.