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Review
. 2023 Jun;12(12):13637-13648.
doi: 10.1002/cam4.5975. Epub 2023 Jun 12.

Understanding the patient experience and treatment benefits in patients with non-small-cell lung cancer with brain metastasis

David Cella  1 , Patrick Y Wen  2 , Claire Ervin  3 , Susan Vallow  4 , Isabelle Gilloteau  4 , Carla DeMuro  3 , Margaret Mordin  3 , Andrea Chassot Agostinho  4 , Jennifer Dine  3
Affiliations
Review

Understanding the patient experience and treatment benefits in patients with non-small-cell lung cancer with brain metastasis

David Cella et al. Cancer Med. 2023 Jun.

Abstract

Background: Despite the high prevalence of brain metastases (BM) secondary to non-small-cell lung cancer (NSCLC) (NSCLC/BM), patients' experiences (symptoms and impacts) are not fully understood. This study sought to understand the patient experience with NSCLC/BM and identify a patient-reported outcome (PRO) measure fit to capture the most important NSCLC/BM symptoms and impacts.

Methods: A targeted literature review was completed; the National Comprehensive Cancer Network (NCCN)/Functional Assessment of Cancer Therapy-Brain Symptom Index, 24-item version (NFBrSI-24) was identified as a relevant measure that assessed the core symptoms and impacts associated with NSCLC/BM. Qualitative interviews composed of concept elicitation and cognitive debriefing with oncologists (n = 3) and adult patients (n = 16) with NSCLC/BM were conducted to confirm the content validity and evaluate the relevance and appropriateness of the NFBrSI-24 for this condition.

Results: The NSCLC/BM symptoms and impacts identified in the literature and reported by oncologists and patients were consistent and captured in the NFBrSI-24. Study participants reported significant burden associated with the symptoms (commonly fatigue, headache) and impacts of NSCLC/BM. Participants indicated that the NFBrSI-24 captured their most salient experiences with NSCLC/BM and that symptom improvement or a delay in progression, as measured by the NFBrSI-24, would be meaningful. During the cognitive debriefing, participants generally indicated that the NFBrSI-24 was comprehensive and easy to understand/answer and that it assessed symptoms they considered most important to treat.

Conclusions: These results suggest that the NFBrSI-24 adequately captures an appropriate measure of NSCLC/BM symptoms and impact.

Keywords: brain metastases; non-small-cell lung cancer; patient-reported outcome measures; qualitative interviews.

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Conflict of interest statement

JD, CE, CD, and MM are full‐time employees of RTI Health Solutions, an independent nonprofit research organization, which was retained by Novartis Pharmaceuticals Corporation to conduct the research which is the subject of this manuscript. Their compensation is unconnected to the studies on which they work. SV, IG, and ACA are employees of Novartis Pharmaceutical Corporation and hold shares and/or stock options in the company. DC is President of FACIT.org. PYW has received research support from AstraZeneca/Medimmune, BeiGene, Celgene, Chimerix, Eli Lily, Genentech/Roche, Kazia, MediciNova, Merck, Novartis, Nuvation Bio, Puma, Servier, Vascular Biogenics, and VBI Vaccines; and serves on advisory boards for AstraZeneca, Bayer, Black Diamond, Boehringer Ingelheim, Boston Pharmaceuticals, Celularity, Chimerix, Day One Bio, Genenta, GlaxoSmithKline, Insightec, Karyopharm, Merck, Mundipharma, Novartis, Novocure, Nuvation Bio, Prelude Therapeutics, Sapience, Servier, Sagimet, Vascular Biogenics, and VBI Vaccines.

Figures

FIGURE 1
FIGURE 1
Symptoms and impacts reported by participants. (A) Symptoms spontaneously reported by ≥2 participants. (B) Most bothersome symptoms as reported by participants. (C) Impacts of non–small‐cell lung cancer with brain metastases reported by participants. ECOG, Eastern Cooperative Oncology Group.
See this image and copyright information in PMC

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