Patient perspectives on ipilimumab across the melanoma treatment trajectory Journal Article


Authors: Shuk, E.; Shoushtari, A. N.; Luke, J.; Postow, M. A.; Callahan, M.; Harding, J. J.; Roth, K. G.; Flavin, M.; Granobles, A.; Christian, J.; Gold, G.; Schoenhammer, M.; Gordon, M.; Cimaglia, N.; Dyson, R.; Goodman-Davis, N.; Colgan, M. N.; Jefferson, I. S.; Munhoz, R.; D'Angelo, S.; Wolchok, J.; Chapman, P.; Chi, P.; Carvajal, R. D.; Hay, J. L.
Article Title: Patient perspectives on ipilimumab across the melanoma treatment trajectory
Abstract: Purpose: Ipilimumab was the first FDA-approved agent for advanced melanoma to improve survival and represents a paradigm shift in melanoma and cancer treatment. Its unique toxicity profile and kinetics of treatment response raise novel patient education challenges. We assessed patient perceptions of ipilimumab therapy across the treatment trajectory. Methods: Four patient cohorts were assessed at different time points relative to treatment initiation: (1) prior to initiation of ipilimumab (n = 10), (2) at weeks 10–12 before restaging studies (n = 11), (3) at week 12 following restaging studies indicating progression of disease (n = 10), and (4) at week 12 following restaging studies indicating either a radiographic response or disease stability (n = 10). Patients participated in a semistructured qualitative interview to assess their experiences with ipilimumab. Quality of life was assessed via the Functional Assessment of Cancer Therapy-General and its Melanoma-specific module. Results: Perceived quality of life was comparable across cohorts, and a majority of the sample understood side effects from ipilimumab and the potential for a delayed treatment response. Patients without progression of disease following restaging studies at week 12 held more positive views regarding ipilimumab compared to patients who had progressed. Conclusion: Patients generally regarded ipilimumab positively despite the risk of unique toxicities and potential for delayed therapeutic responses; however, those with progression expressed uncertainty regarding whether taking ipilimumab was worthwhile. Physician communication practices and patient education regarding realistic expectations for therapeutic benefit as well as unique toxicities associated with ipilimumab should be developed so that patients can better understand the possible outcomes from treatment. © 2017, Springer-Verlag Berlin Heidelberg.
Keywords: adult; cancer survival; clinical article; treatment outcome; treatment response; aged; cancer growth; cancer patient; ipilimumab; melanoma; cohort analysis; patient education; doctor patient relation; qualitative research; perception; semi structured interview; metastatic melanoma; quality of life assessment; human; male; female; priority journal; article; fact-g; fact-m; patient-reported quality of life; functional assessment of cancer therapy general; functional assessment of cancer therapy melanoma
Journal Title: Supportive Care in Cancer
Volume: 25
Issue: 7
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2017-07-01
Start Page: 2155
End Page: 2167
Language: English
DOI: 10.1007/s00520-017-3621-z
PROVIDER: scopus
PUBMED: 28247127
PMCID: PMC5651412
DOI/URL:
Notes: Article -- Export Date: 3 July 2017 -- Source: Scopus
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MSK Authors
  1. Jedd D Wolchok
    905 Wolchok
  2. Michael Andrew Postow
    361 Postow
  3. James Joseph Harding
    250 Harding
  4. Ping Chi
    172 Chi
  5. Paul Chapman
    326 Chapman
  6. Sandra Pierina D'Angelo
    252 D'Angelo
  7. Margaret Kathleen Callahan
    197 Callahan
  8. Jennifer L Hay
    264 Hay
  9. Elyse Shuk
    62 Shuk
  10. Marta Nalysnyk Colgan
    3 Colgan
  11. Mallorie Laura Gordon
    6 Gordon