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. 2021 Mar 22:12:583126.
doi: 10.3389/fphar.2021.583126. eCollection 2021.

Attitudes and Practices of Immune Checkpoint Inhibitors in Chinese Patients With Cancer: A National Cross-Sectional Survey

Luping Zhang  1 , Jun Wang  2 , Bicheng Zhang  3 , Qian Chu  4 , Chunxia Su  5 , Hao Wu  6 , Xiaobing Chen  7 , Baocheng Wang  8 , Yongmei Yin  6 , Bo Zhu  1 , Jianguo Sun  1
Affiliations

Attitudes and Practices of Immune Checkpoint Inhibitors in Chinese Patients With Cancer: A National Cross-Sectional Survey

Luping Zhang et al. Front Pharmacol. .

Abstract

Immune-checkpoint inhibitors (ICIs) are revolutionizing the field of immuno-oncology. Side effects and tumor microenvironment currently represent the most significant obstacles to using ICIs. In this study, we conducted an extensive cross-sectional survey to investigate the concept and practices regarding the use of ICIs in cancer patients in China. The results provide real-world data on the adverse events (AEs) of ICIs and the factors influencing the use of ICIs. This survey was developed by the Expert Committee on Immuno-Oncology of the Chinese Society of Clinical Oncology (CSCO-IO) and the Expert Committee on Patient Education of the Chinese Society of Clinical Oncology (CSCO-PE). The surveys were distributed using a web-based platform between November 29, 2019 and December 21, 2019. A total of 1,575 patients were included. High costs (43.9%), uncertainty about drug efficacy (41.2%), and no reimbursement from medical insurance (32.4%) were the factors that prevented the patients from using ICIs. The patients were most concerned about the onset time or effective duration of ICIs (40.3%), followed by the indications of ICIs and pre-use evaluation (33.4%). Moreover, 9.0, 57.1, 21.0, and 12.9% of the patients reported tumor disappearance, tumor volume reduction, no change in tumor volume, and increased tumor volume. Among the patients who received ICIs, 65.7% reported immune-related AEs (irAEs); 96.1% reported mild-to-moderate irAEs. Cancer patients in China had a preliminary understanding of ICIs. Yet, the number of patients treated with ICIs was small.

Keywords: adverse effects; attitude; immunotherapy; practice; survey.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Province distribution of respondents. Valid surveys were collected from 30 provinces. The highest number of respondents were from the Chongqing area. Two respondents, who completed the survey outside China, are not shown.
FIGURE 2
FIGURE 2
Frequency of the answers regarding the methods for learning about immune checkpoint inhibitors.
FIGURE 3
FIGURE 3
Frequencies of the approaches and preferences of the patients for acquiring immune checkpoint inhibitor treatment information. (A) Preferred types of written material for information about checkpoint inhibitors. (B) Preferred types of information about checkpoint inhibitors. (C) Preferred types of online and offline activities about checkpoint inhibitors. (D) Appreciation of the patients regarding wardmate group, patient education official accounts, APP, and rehabilitation organization about checkpoint inhibitors. (E) Patients’ need for oncology services.
FIGURE 4
FIGURE 4
Factors influencing the use of ICIs in patients. (A) Patients’ reasons for not using immune checkpoint inhibitor (ICI) treatment. (B) Patients’ reasons for using ICI treatment.
See this image and copyright information in PMC

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