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Resistance to treatment is one of the major themes in cancer research. Despite this, the definition and clinical implications of resistance to treatment remain under-explored, and patient-physician communication in this context still constitutes a challenge. When resistance to cancer treatments occurs, physicians not only have to explain to the patient the phenomenon of resistance, often based on complex results (biological results, genomic tests, imaging, etc.), but also need to offer alternative therapies, whilst fostering shared medical decision-making. These different tasks are particularly challenging for clinicians, especially since there are large individual differences at patient level. Indeed, each patient has his or her own unique information needs, capacity for understanding, and level of desire to participate in treatment decisions.
Although a challenge, better communicating around resistance to treatment carries many potential benefits. Indeed, in similar contexts of announcement of bad news and choice of care, Parker and collaborators (1) have highlighted the positive impact of individualized care, respecting the needs, quality of care, and quality of life of patients. Given the clinical stake, and the lack of scientific knowledge devoted to communication in the context of resistance to treatment, it appears necessary to better understand its modalities. In this perspective, research has proven the value of tools for supporting communication, including the issue of question booklets for patients. These tools provide patients with a list of questions submitted to them before the medical consultation, and which they can ask during the consultation, and throughout the treatment. This tool fosters communication by helping the patient obtain a level of information that is adapted to his or her needs and experience, and thus, to be better prepared for care. Despite significant interest for these booklets in the field of oncology, none has yet been developed in the specific context of resistance to treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Metastatic Uveal Melanoma | Other | Questionnaires and semi-structured individual interviews with patients with Metastatic Uveal Melanoma |
|
| Triple Negative Breast Cancer | Other | Questionnaires and semi-structured individual interviews with patients with Triple Negative Breast Cancer |
|
| Luminal B Breast Cancer | Other | Questionnaires and semi-structured individual interviews with patients with Luminal B Breast Cancer |
|
| Pediatric Cancer | Other | Questionnaires and semi-structured individual interviews with parents of children with cancer. |
|
| Expert Patients | Other | Focus groups (or group interviews) and DELPHI consensus method with expert patients |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Questionnaires | Behavioral | Questionnaires |
|
| Measure | Description | Time Frame |
|---|---|---|
| List of patients' needs, particularly regarding communication with physicians | List of patients' needs in support, and information delivered by physicians in consultation | 18 months |
| Items of communication booklet | Number and content of items, number of categories / themes, | 18 months |
| Acceptability of the booklet evaluated | Items and issues revised and reformulated by the experts. Application of the booklet in the determined clinic: Modes of administration of the booklet and patients concerned identified. Implementation of the tool and relevant patients identified | 18 months |
| Content of communication booklet validated | Consensus criteria: Consensus can be considered to have been reached if the majority of participants (70% or more) rank an item similarly | 18 months |
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Inclusion Criteria:
Patients:
Parents of a sick child:
Expert patients:
Professionals:
Exclusion Criteria:
Patients & parents of a sick child:
Expert patients:
Professionals:
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| Name | Affiliation | Role |
|---|---|---|
| Sylvie DOLBEAULT, PHD | Institut Curie | Study Director |
| Anne BREDART, PHD | Institut Curie | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Curie | Paris | 75005 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39198868 | Derived | Rault A, Dolbeault S, Terrasson J, Bouleuc C, Cottu P, Piperno-Neumann S, Rodrigues M, Vaflard P, Bredart A. Facilitating patient-oncologist communication in advanced treatment-resistant cancer: development and feasibility testing of a question prompt list. Pilot Feasibility Stud. 2024 Aug 28;10(1):116. doi: 10.1186/s40814-024-01543-y. | |
| 35019850 |
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Investigators will share de-identified data sets with interested reserachers, educators or clincians. Materials generated under the project will be disseminated in accordance with Institut Curie policies.
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Data requests can be submitted starting 9 months after article publication and will made accessible for up to 12 months.
Access to trial individual participant data can be requested by qualified researchers engaging in independent scientific reserach, and will be provided following review and approval of a research proposal and Statistical Analysis Plan (SAP) and execution of a data sharing agreement (DSA).
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To meet our objectives, the research team has developed a cross-sectional and mixed exploratory research according to three successive steps :
Step 1: Questionnaires and semi-structured individual interviews will : (a) to identify patients' needs and (b) to build the initial contents of the tool, items and issues. Four patients' populations will be recruited in this step : metastatic uveal melanoma, triple negative breast cancer, luminal B breast cancer, and pediatric cancer. This step will be conducted in parallel with these populations.
Step 2 : Focus groups : to evaluate the acceptability and applicability of the tool in this clinical context with expert patients, researchers and clinicians.
Step 3 : The DELPHI consensus method : to validate the contents of the booklet for patients with expert patients, researchers and clinicians.
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| Researchers and Clinicians | Other | Focus groups (or group interviews) and DELPHI consensus method with Researchers and Clinicians |
|
| Semi-structured individual interviews | Behavioral | Semi-structured individual interviews |
|
| Focus Group | Other | Focus Group |
|
| DELPHI Consensus Method | Other | DELPHI Consensus Method |
|
| Bredart A, Rault A, Terrasson J, Seigneur E, De Koning L, Hess E, Savignoni A, Cottu P, Pierga JY, Piperno-Neumann S, Rodrigues M, Bouleuc C, Dolbeault S. Helping Patients Communicate With Oncologists When Cancer Treatment Resistance Occurs to Develop, Test, and Implement a Patient Communication Aid: Sequential Collaborative Mixed Methods Study. JMIR Res Protoc. 2022 Jan 12;11(1):e26414. doi: 10.2196/26414. |
| ID | Term |
|---|---|
| D000098943 | Uveal Melanoma |
| D064726 | Triple Negative Breast Neoplasms |
| D009369 | Neoplasms |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D014604 | Uveal Neoplasms |
| D005134 | Eye Neoplasms |
| D009371 | Neoplasms by Site |
| D005128 | Eye Diseases |
| D014603 | Uveal Diseases |
| D001943 | Breast Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| D017144 | Focus Groups |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
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