Supportive Oncology Care at Home Intervention for Patients With Pancreatic Cancer.

Autor:	Nipp RD; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Gaufberg E; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Vyas C; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Azoba C; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Qian CL; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Jaggers J; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Weekes CD; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Allen JN; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Roeland EJ; Division of Hematology/Medical Oncology, School of Medicine, Oregon Health and Science University, Portland, OR., Parikh AR; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Miller L; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Wo JY; Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Smith MH; Medically Home Group, Boston, MA., Brown PMC; Medically Home Group, Boston, MA., Shulman E; Medically Home Group, Boston, MA., Fernandez-Del Castillo C; Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Kimmelman AC; Department of Radiation Oncology, Perlmutter Cancer Center NYU Langone Medical Center, New York, NY., Ting D; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Hong TS; Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Greer JA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA., Ryan DP; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., Temel JS; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA., El-Jawahri A; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2022 Oct; Vol. 18 (10), pp. e1587-e1593. Date of Electronic Publication: 2022 Jul 13.
DOI:	10.1200/OP.22.00088
Abstrakt:	Purpose: We sought to determine the feasibility of delivering a Supportive Oncology Care at Home intervention among patients with pancreatic cancer. Methods: We prospectively enrolled patients with pancreatic cancer from a parent trial of neoadjuvant fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFIRINOX). The intervention entailed (1) remote monitoring of patient-reported symptoms, vital signs, and body weight; (2) a hospital-at-home care model; and (3) structured communication with the oncology team. We defined the intervention as feasible if ≥ 60% of patients enrolled in the study and ≥ 60% completed the daily assessments within the first 2-weeks of enrollment. We determined rates of treatment delays, urgent clinic visits, emergency department visits, and hospitalizations among those who did (n = 20) and did not (n = 24) receive Supportive Oncology Care at Home from the parent trial. Results: From January 2019 to September 2020, we enrolled 80.8% (21/26) of potentially eligible patients. One patient became ineligible following consent because of moving out of state, resulting in 20 participants (median age = 67 years). In the first 2 weeks of enrollment, 65.0% of participants completed all daily assessments. Overall, patients reported 96.1% of daily symptoms, 96.1% of daily vital signs, and 92.5% of weekly body weights. Patients receiving the intervention had lower rates of treatment delays (55.0% v 75.0%), urgent clinic visits (10.0% v 25.0%), and emergency department visits/hospitalizations (45.0% v 62.5%) compared with those not receiving the intervention from the same parent trial. Conclusion: Findings demonstrate the feasibility and acceptability of a Supportive Oncology Care at Home intervention. Future work will investigate the efficacy of this intervention for decreasing health care use and improving patient outcomes. Competing Interests: Ryan D. NippThis author is an Associate Editor for JCO Oncology Practice. Journal policy recused the author from having any role in the peer review of this manuscript. Colin D. WeekesHonoraria: Celgene, Lilly, BayerConsulting or Advisory Role: Celgene, Merrimack, IpsenResearch Funding: Celgene, Genentech/Roche, AstraZeneca, Dicephera Pharmaceuticals Inc, Novartis, Actuate Therapeutics Eric J. RoelandConsulting or Advisory Role: Napo Pharmaceuticals, AIM Specialty Health, Helsinn Therapeutics, Byomass, Veloxis, PRA Health, Actimed Therapeutics, Takeda, MeterHealthExpert Testimony: Regents of the University of California Aparna R. ParikhStock and Other Ownership Interests: C2i genomicsConsulting or Advisory Role: Lilly, Natera, Checkmate Pharmaceuticals, Pfizer, Roche/Genentech, Inivata, Biofidelity, Guardant HealthResearch Funding: Plexxikon (Inst), Bristol Myers Squibb (Inst), Genentech (Inst), Guardant Health (Inst), Array BioPharma (Inst), Lilly (Inst), Novartis Pharmaceuticals UK Ltd (Inst), PureTech (Inst), PMV Pharma, Mirati Therapeutics (Inst), Daiichi Sankyo (Inst) Jennifer Y. WoHonoraria: PERResearch Funding: Genentech/Roche (Inst)Travel, Accommodations, Expenses: Lynx Group Melissa Hennessey SmithEmployment: Medically HomeStock and Other Ownership Interests: Medically HomeResearch Funding: Medically HomeTravel, Accommodations, Expenses: Medically Home Patricia M.C. BrownEmployment: Medically HomeStock and Other Ownership Interests: Medically Home Group IncConsulting or Advisory Role: AllscriiptsResearch Funding: Medically Home Group IncTravel, Accommodations, Expenses: Medically Home Group Eliza ShulmanEmployment: Medically HomeLeadership: Medically HomeStock and Other Ownership Interests: Medically Home Alec C. KimmelmanStock and Other Ownership Interests: Vescor Therapeutics, Rafael PharmaceuticalsConsulting or Advisory Role: Vescor Therapeutics, AbbVie, DecipheraPatents, Royalties, Other Intellectual Property: Inventor on patents pertaining to Kras-regulated metabolic pathways, redox control pathways in pancreatic cancer, targeting GOT1 as a therapeutic approach and the autophagic control of iron metabolism, and targeting alanine transport in pancreatic cancer David TingLeadership: PanTher TherapeuticsStock and Other Ownership Interests: PanTher Therapeutics, ROME Therapeutics, TellBioConsulting or Advisory Role: ROME Therapeutics, Millipore, Foundation Medicine, Pfizer, NanoString Technologies, Tekla Capital Management, Ikena OncologyResearch Funding: ACD Biotechne (Inst), PureTech (Inst), Ribon Therapeutics (Inst)Patents, Royalties, Other Intellectual Property: Patent licensed to Rome Therapeutics by my Institution (Inst); patent license to PanTher Therapeutics (Inst), patent license to TellBio Inc (Inst) Theodore S. HongStock and Other Ownership Interests: PanTher TherapeuticsConsulting or Advisory Role: Merck, Synthetic Biologics, Novocure, Syndax, Boston ScientificResearch Funding: Taiho Pharmaceutical (Inst), AstraZeneca (Inst), IntraOp (Inst), Tesaro (Inst), Bristol Myers Squibb (Inst), Ipsen (Inst) Joseph A. GreerResearch Funding: NCCN/AstraZeneca (Inst), Gaido Health/BCG Digital Ventures (Inst), Blue Note Therapeutics (Inst)Patents, Royalties, Other Intellectual Property: Royalties from Springer Publishing Company for the edited book, The Massachusetts General Hospital Handbook of Behavioral Medicine. David P. RyanStock and Other Ownership Interests: MPM Capital, Acworth Pharmaceuticals, Thrive Earlier Detection Corp, Exact SciencesHonoraria: UpToDate, Research to PracticeConsulting or Advisory Role: MPM Capital, Oncorus, Gritstone Bio, Maverick Therapeutics, TCR2 Therapeutics, Twentyeight-Seven Therapeutics, Innocrin PharmaResearch Funding: Stand up to Cancer (Inst)Patents, Royalties, Other Intellectual Property: McGraw Hill Chapter Royalties, Johns Hopkins University PressExpert Testimony: Boehringer IngelheimOther Relationship: TCR2 Therapeutics Areej El-JawahriConsulting or Advisory Role: AIM Specialty Health, Novartis, GlaxoSmithKline, IncyteNo other potential conflicts of interest were reported.
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