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Development and Validation of a Health-related Quality of Life Instrument

Completed
Conditions
Cancer
Interventions
Other: Questionnaire
Other: Focus groups and individual interviews
Registration Number
NCT02651831
Lead Sponsor
University Health Network, Toronto
Brief Summary

This study aims to develop a health related quality of life (HRQOL) patient reported outcome (PRO) for patients receiving immune checkpoint modulator (ICM) therapy. This instrument could be used to in clinical trials to evaluate HRQOL for patients treated with novel ICMs and ICM combinations that might ultimately influence decisions about regulatory approval, as well as improved understanding of chronic treatment effects on patient well-being, understanding reasons for treatment non-adherence, and developing strategies to improve adherence and evaluating clinical outcomes.

Detailed Description

Immune Checkpoint Modulators (ICMs) are associated with significant adverse events. Currently there are no validated patient reported outcome (PRO) tools to assess health related quality of life (HRQOL) specifically in patients receiving ICMs. HRQOL is a multidimensional concept of a patient's perceived well-being that can be affected by disease and treatment. There is an urgent need to assess the impact of ICMs on HRQOL, to better understand the balance between efficacy and toxicity with these agents.

This study aims to develop a health related quality of life (HRQOL) patient reported outcome (PRO) for patients receiving immune checkpoint inhibitor (ICM) therapy (FACT-ICM). The core domains of the FACT-ICM will include physical, emotional, family and social, and functional well being. In addition, the proposed study will develop a toxicity sub-scale related to resultant toxicities from ICM therapy.

The HRQOL will be developed through focus groups and interviews with patients treated with ICMs, and clinicians treating patients with ICMs, to understand how treatment with ICMs impacts HRQOL, as well as explore general experiences, insights and concerns of those receiving ICM therapies.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
85
Inclusion Criteria

Patient Criteria

  • Cancer diagnosis (any type, advanced or metastatic stage);
  • Treatment with an agent or agents that modulate an immune checkpoint (any line of therapy);
  • Age ≥ 18;
  • English-speaking;
  • ECOG PS 0-3
  • Able to complete questionnaires independently
  • Able to provide informed consent.
  • Completed treatment within a year of enrolment

Clinician Criteria

  • Must either treat patients with ICMs or manage side effects of patients treated with ICMs
  • Be able to attend interviews and participate in discussions as part of the study
Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
2C: To determine responsiveness and MCIDQuestionnaireResponsiveness testing: Patients will complete FACT-ICM within a week of starting treatment, then while on treatment and within 30 days after end of treatment (EOT) with ICMs. MCID testing: In addition to the FACT-ICM score, patients undergoing serial assessment for responsiveness will also indicate how much better or worse they are using a 5-point rating scale.
1A: Content ValidationFocus groups and individual interviewsUp to 4 focus groups of 6-10 cancer patients each will be conducted each lasting approximately 90 mins. An additional 10 to 15 patients will undergo individual semi-structured interviews each lasting around 60 minutes. 10-12 expert clinicians experienced in treating patients with ICMs or managing ICM toxicities will participate in a survey, and group or individual interviews.
2B: To confirm construct validityQuestionnaireTo evaluate discriminative properties of FACT-ICM, scores will be compared between pre-defined groups of patients where differences are expected.
1B: Face ValidityQuestionnairePatients who have been and are being treated with ICMs to complete draft questionnaire (FACT-ICM). Some patients who were involved in the first round of interviews will be re-interviewed, and interview naïve patients will also be included.
2A: To measure test-retest reliabilityQuestionnairePatients to complete FACT-ICM at at two time points separated by 5 to 14 days.
Primary Outcome Measures
NameTimeMethod
Confirmatory factor analysis of FACT-ICM PRO tool variables compared to content analysis and qualitative descriptives of patient focus groups and interviews in target group6 months
Secondary Outcome Measures
NameTimeMethod
Comparison of FACT-ICM scores between pre-defined groups of patients where differences are expected6 months
FACT-ICM change scores from baseline to within 30 days after end of treatmentBaseline, an average of 3 months, and within 30 days after end of treatment
Change in MCID values from baseline to within 30 days after end of treatmentBaseline, an average of 3 months, and within 30 days after treatment
Change of score for each domain and also the total FACT-ICM score at baseline to 5-14 days for patients with minimal change in status5-14 days

Trial Locations

Locations (1)

Princess Margaret Cancer Centre

🇨🇦

Toronto, Ontario, Canada

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