Treatment Decision Drivers in Stage III Non-Small-Cell Lung Cancer: Outcomes of a Web-Based Survey of Oncologists in the United States
| Autor: | E.C. Faulkner, Ion Cotarla, Daryl S. Spinner, Adam Yagui-Beltran, Marissa C. Carroll, Marnie L. Boron, Shawna L. Cullen, Surbhi Shah |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Lung Neoplasms Clinical Decision-Making MEDLINE 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Surveys and Questionnaires medicine Humans Patient treatment 030212 general & internal medicine Stage (cooking) Practice Patterns Physicians' Web based survey Neoplasm Staging Oncologists Internet Oncology (nursing) business.industry Health Policy Chemoradiotherapy United States Stage III Non-Small Cell Lung Cancer Cross-Sectional Studies Oncology 030220 oncology & carcinogenesis Family medicine Treatment decision making Immunotherapy business |
| Zdroj: | JCO oncology practice. 16(10) |
| ISSN: | 2688-1535 |
| Popis: | PURPOSE: We conducted a cross-sectional survey of practicing medical oncologists in the United States to obtain insight into physician and patient treatment decision making in stage III non–small-cell lung cancer (NSCLC). METHODS: A convenience sample of 150 oncologists completed a 38-question Web-based survey in January 2019. RESULTS: Surveyed oncologists (82% community based) had an average of 15 years of clinical experience and had treated an average of 20 patients newly diagnosed with stage III NSCLC in the previous 6 months. Oncologists reported presenting 55% of their patients with stage III NSCLC to tumor boards. For patients with new unresectable stage III NSCLC seen in the previous 6 months, concurrent chemoradiation therapy (cCRT) was reported as the initial treatment in an average of 48% of patients. The most frequent reason for delays in starting the initial chosen treatment was insurance preauthorization processes (reported by 65% of oncologists). A total of 55% of all patients with unresectable stage III NSCLC who received cCRT went on to receive consolidation immunotherapy; for patients who received consolidation chemotherapy after cCRT, the rate of immunotherapy was lower (42%). Biomarker test results were given as the reason for oncologists not recommending immunotherapy after cCRT in approximately a quarter of cases. The 112 oncologists with eligible patients who declined immunotherapy reported previous treatment fatigue as the reason in 34% of patients and insurance challenges in 19% of patients. CONCLUSION: Oncologists reported notable deviations from treatment guidelines for stage III NSCLC. Our findings highlight important opportunities to improve decision making and the coordination of care in stage III NSCLC. |
| Databáze: | OpenAIRE |
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