https://orcid.org/0000-0001-5031-302X
Abstract
Purpose
To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the “patient voice” describing how CIM impacts their daily lives.
Participants and Methods
Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: “In your own words, please describe how side effects from myelosuppression have impacted your life.”
Results
Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1–10 scale of “bothersomeness”). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24–43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family.
Conclusion
Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.
Abbreviations
CIM, chemotherapy-induced myelosuppression; CRC, colorectal cancer; HCP, health care provider; IRB, institutional review board; PA, physician assistant; QoL, quality of life; US, United States.
Data Sharing Statement
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethics Approval and Informed Consent
The study was conducted in accordance with the Declaration of Helsinki, and electronic consent was obtained from all participants prior to study entry. All participants were informed about the purpose of the survey. The study was reviewed by the Sterling IRB and granted exemption status according to the Department of Health and Human Services research criteria, signifying that full IRB review was not required.
Consent for Publication
All named authors meet the International Committee of Medical Journal Editors criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Acknowledgments
We give special thanks to the patients who participated in the survey, and to Dr Upal K Basu Roy from the LUNGevity Foundation (lung cancer advocacy community) for his involvement and authorship. Medical writing assistance in the preparation of this article was provided by Fiona Bolland from Alligent Europe (Envision Pharma Group). Support for this assistance was funded by G1 Therapeutics, Inc.
Disclosure
Robert S. Epstein is a consultant for G1 Therapeutics, Inc., and serves on the board for Decipher Biosciences, Fate Therapeutics, Illumina, Proteus Digital, and Veracyte. Upal K. Basu Roy has received research funding unrelated to this project from Astra Zeneca, Bristol Myers Squibb Foundation, and Merck. Matti Aapro has served as a consultant for Amgen, Bristol Myers Squibb, Daiichi Sankyo, Fresenius Kabi, G1 Therapeutics, Inc., Genomic Health, Helsinn Healthcare, Merck KGaA, Merck, Novartis, Pfizer, Pierre Fabre, Roche, Sandoz, Tesaro, and Vifor Pharma; is on the speakers’ bureau for Accord Research, Amgen, Biocon, Dr Reed, Genomic Health, Helsinn Healthcare, Mundipharma, Novartis, Pierre Fabre, Pfizer, Roche, Sandoz, Taiho Pharmaceutical, Tesaro, and Vifor Pharma; and has received research funding from Helsinn Healthcare, Novartis, Pierre Fabre, and Sandoz. Tehseen Salimi was an employee of G1 Therapeutics, Inc., at the time of study completion, and is currently an employee of Taiho Oncology, Inc. Donald Moran is an employed consultant for G1 Therapeutics, Inc. JoAnn Krenitsky is a consultant for G1 Therapeutics, Inc. Megan L. Leone-Perkins is a consultant for HealthiVibe, a division of Corrona LLC. Cynthia Girman and Courtney Schlusser are consultants for G1 Therapeutics, Inc., and other pharmaceutical companies through CERobs Consulting and Epstein Health. Jeffrey Crawford has served as an advisor to Amgen, Coherus, G1 Therapeutics, Inc., and Pfizer. The authors report no other conflicts of interest in this work.