1626MO - Treatment expectations and preferences for quality versus quantity of life in patients with advanced soft tissue sarcomas starting palliative 1st line chemotherapy

Background

Palliative chemotherapy is the mainstay of treatment for patients with advanced soft tissue sarcomas (STS), however prognosis is limited (median overall survival 12-19 months). In this setting, patient values and preferences -though understudied- are central to treatment decisions. Our objectives were to explore priorities for quality versus quantity (length) of life (QoL vs. LoL) and treatment expectations in patients starting chemotherapy (CTx).

Methods

The HOLISTIC study is an international prospective cohort study assessing health-related quality of life in advanced STS patients receiving palliative CTx. Participants completed a baseline questionnaire before starting 1^st-line CTx, including treatment expectations and preferences for QoL vs. LoL. Chi-squared and Fisher’s exact tests were used to evaluate associations between patient characteristics, preferences and expectations.

Results

In total, 137 patients with advanced STS participated (U.K: n=72, Netherlands: n=65). Median age was 62 years (range 27-79). Preference for extended LoL (48%) was slightly more common than preference for QoL (41%); 9% valued LoL and QoL equally. Younger patients (aged<40 years; P=0.002) and those who were employed (P=0.019) prioritised LoL. U.K participants and those with dependent children tended to prioritise LoL, however, this trend was not statistically significant. Most patients thought that CTx would help them to live longer (88%), 27% believed CTx was potentially curative and 67% thought that it would improve cancer-related problems. Belief that treatment could be curative was more common among ‘non-Caucasian’ participants (n=22; P=0.016). Gender, marital status, education level, performance status, baseline health-related quality of life, disease extent and time period since advanced STS diagnosis were not associated with preferences or expectations.

Conclusions

These data show heterogenous preferences and expectations among advanced STS patients starting 1^st line chemotherapy, supporting personalised decision making. Treatment regret will be a topic of further study.

Clinical trial identification

NCT03621332.

Editorial acknowledgement

Legal entity responsible for the study

Royal Marsden NHS Foundation Trust and Institute of Cancer Research.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.