Growth Mindset: Implementing Palliative Care in the Phase I Clinical Trial Setting (SA313B)

• Published in: Journal of pain and symptom management 2023-03, Vol.65 (3), p.e303-e304
• Main Authors: DeCarli, Kathryn, Guyer, Dana, Lyons, Margaret, Carneiro, Benedito
• Format: Article
• Language: English
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.12.130

1. Define unique palliative care needs of the oncology phase I clinical trial patient population 2. Utilize a framework for integrated specialty palliative care provided in the phase I trial setting Emerging data support an integrated palliative care (PC) model for cancer patients on phase I clinical trials. This population has high symptom burden resulting in hospitalization (41%), poor prognosis (median OS 10.1 months from time of phase I enrollment), frequent transitions in care, and low rates of ACP completion (39%). Ferrell et al showed improved emotional well-being and psychological distress scores for phase I patients receiving a nurse-delivered PC intervention. We propose a pilot study to assess the feasibility, acceptability, and impact of an integrated specialty PC model at an academic cancer center. To determine whether standardized referrals to tertiary PC affect quality of life, ACP and prognostic awareness among patients with advanced cancer enrolled on phase I trials. All patientsenrolled to a phase I clinical trial at Lifespan Cancer Institute in Providence RI will be referred to specialty PC and eligible for this prospective pilot study. Patientss who consent will complete validated surveys (FACIT-Pal, FACIT-TS-PS, and PTPQ) and meet with a PC physician at designated intervals during phase I participation. At the time of phase I unenrollment, they will continue meeting with PC. PC visits will be structured and flexible to include discussion of prognostic awareness, patient's goals, ACP, and symptom management. We will present our experience at an academic cancer center building an integrated PC model in the phase I clinic as a trial in progress. We anticipate enrollment of ∼30 patients and survey data. Patients with advanced cancer on phase I clinical trials represent a vulnerable population with unique PC needs that may be addressed by integrated PC and standardized referral to tertiary PC.