Hit it hard: qualitative patient perspectives on the optimisation of immune checkpoint inhibition

• Published in: British journal of cancer 2024-08, Vol.131 (3), p.515-523
• Main Authors: Merrick, Sophie, Rush, Hannah L., Daniels, Susanna, Fielding, Alison, Deveson Kell, Sharon, Pickering, Lisa, Langley, Ruth E., South, Annabelle, Gilbert, Duncan C.
• Format: Article
• Language: English
• Subjects: 692/4028; 692/4028/67/1059/2325; Adult; Aged; Aged, 80 and over; Biomedical and Life Sciences; Biomedicine; Cancer Research; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - immunology; Clinical trials; Drug Resistance; Epidemiology; Female; Focus Groups; Humans; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - therapeutic use; Kidney Neoplasms - drug therapy; Kidney Neoplasms - immunology; Male; Melanoma; Melanoma - drug therapy; Melanoma - immunology; Middle Aged; Molecular Medicine; Oncology; Patients; Qualitative Research; Quality of Life; Renal cell carcinoma; Toxicity
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-024-02756-x

Background Immune checkpoint inhibitors have transformed the treatment landscape of many cancers, including melanoma and renal cell carcinoma (RCC). Randomised trials are evaluating outcomes from reduced ICI treatment schedules with the aim of improving quality of life, tolerability, and cost-effectiveness. This study aims to provide insight into patient and carer’s perspectives of these trials. Methods Seven focus groups were conducted with 31 people with stage IV melanoma, RCC, or caregivers for people receiving ICI. Transcripts were analysed using reflexive thematic analysis. Results Three themes were generated: 1) “Treatment and clinic visits provide reassurance”: reducing hospital visits may not improve quality of life. 2) “Assessment of personal risk versus benefit”: the decision to participate in an ICI optimisation trial is influenced by treatment response, experience of toxicity and perceived logistical benefits based on the individual’s circumstances. 3) “Pre-existing experience and beliefs about how treatment and trials work” , including the belief that more treatment is better, influence views around ICI optimisation trials. Conclusion This study provides insight into recruitment challenges and recommends strategies to enhance recruitment for ongoing ICI optimisation trials. These findings will influence the design of future ICI optimisation trials ensuring they are acceptable to patients.