Computer-Generated Quality of Life Assessment Program for Advanced Non-Small Cell Lung Cancer Patients (LUNL2)

This study has been completed.
Sponsor:
Collaborator:
Mount Sinai Hospital, Canada
Information provided by:
University Health Network, Toronto
ClinicalTrials.gov Identifier:
NCT01337102
First received: April 5, 2011
Last updated: December 13, 2011
Last verified: December 2011
  Purpose

In the treatment of advanced cancer, maximizing quality of life (QoL) is a fundamental goal for oncologists and their patients. In order to achieve this goal, some form of systematic and reliable QoL assessment is needed in routine clinical practice to evaluate the impact of advanced cancer treatments on QoL. The Lung Cancer Symptom Scale (LCSS) is a validated site-specific QoL measure designed for use in patients with lung cancer undergoing treatment. Recently it has been developed into an electronic form that uses a hand-held pocket personal computer (pc) to enhance collection and presentation of QoL assessments into clinical trials and patient care. This study will evaluate the impact of this computer-generated QoL (LCSS-QL) assessment on treatment practices for advanced lung cancer patients using a randomized trial design. The investigators hypothesize that a Computer-Generated Quality of Life Assessment Program will positively impact treatment patterns for patients with lung cancer.

Specifically, the investigators hypothesize:

  1. Use of the LCSS-QL will increase and accelerate referral to and use of palliative care services;
  2. Use of the LCSS-QL will decrease the duration of palliative chemotherapy treatment with earlier identification of lack of benefit in some patients;
  3. Use of the LCSS-QL may decrease the use of imaging tests to assess objective tumor response as an indicator of treatment benefit.

Maximizing quality of life is one of the most important goals of palliative chemotherapy in the treatment of advanced lung cancer. If this simple practical tool can be demonstrated to improve palliative management of these patients, including optimizing duration of chemotherapy and use of palliative and supportive services based on patient QoL response, this will dramatically improve the quality of care provided to advanced lung cancer patients. This study will also provide a springboard for other ways to incorporate computer-generated QoL measurement in treatment decision-making in advanced cancer patients, including in other tumor types such as advanced breast and colorectal cancer.


Condition Intervention
Non Small Cell Lung Cancer
Procedure: Physician Receives QoL results
Procedure: Physician Does not receive the results

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single Blind (Investigator)
Primary Purpose: Supportive Care
Official Title: Randomized Trial to Investigate the Impact of a Computer-Generated Quality of Life Assessment Program on Treatment Patterns for Advanced Non-Small Cell Lung Cancer Patients (LUNL2)

Resource links provided by NLM:


Further study details as provided by University Health Network, Toronto:

Primary Outcome Measures:
  • Number of Palliative care Referrals. [ Time Frame: Approximately 12 - 18 weeks ] [ Designated as safety issue: No ]
    To assess the impact of use of the LCSS-QL on palliative care referrals;

  • Number of palliative first-line chemotherapy cycles administered. [ Time Frame: Approximately 12 - 18 weeks ] [ Designated as safety issue: No ]
    To assess the impact of use of the LCSS-QL on the number of palliative first-line chemotherapy cycles administered


Secondary Outcome Measures:
  • Use of supportive treatments. [ Time Frame: 12 - 18 weeks ] [ Designated as safety issue: No ]
    To assess the impact of use of the LCSS-QL on the use of supportive treatments including radiotherapy, home oxygen, transfusion or growth factor support, community care support;

  • Number of imaging tests ordered. [ Time Frame: Approximately 12 - 18 weeks ] [ Designated as safety issue: No ]
    To assess the impact of use of the LCSS-QL on the number of imaging tests ordered to evaluate patient response to therapy.

  • Differences between study arm scores [ Time Frame: Approximately 12 - 18 weeks ] [ Designated as safety issue: No ]
    To compare LCSS-QL scores of patients between the two study arms


Enrollment: 103
Study Start Date: November 2004
Study Completion Date: November 2011
Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Physician to receive results
Arm 1 Physician to receive the results of the Lung QoL scale
Procedure: Physician Receives QoL results
Patient completes the Lung Cancer QoL scale on the Palm held computer device and the Physician receives the print out of the results.
Physician Does Not Receive Results
Arm 2 Physician does not receive the results of the Lung QoL scale
Procedure: Physician Does not receive the results
Patient completes the Lung Cancer QoL scale on the Palm held computer device and the Physician does not receive the print out of the results.

Detailed Description:

Study Design The study will be conducted using an unblinded, randomized trial design. Patients starting systemic therapy for advanced NSCLC will be invited to complete the LCSS-QL upon starting first-line systemic chemotherapy and then prior to subsequent treatment visits (every 3 weeks). Patients will then be randomized at baseline to whether or not their physician will receive this information at the time of clinic visits for the duration of study participation. Randomization codes will be generated by computer program, with stratification by physician, platinum-based versus non-platinum based therapy and Eastern Cooperative Group Performance Status 0 and 1 versus 2 and 3. All patients complete the LCSS-QL at baseline, at the beginning of each cycle of chemotherapy, and at follow up visits until disease progression (initiation of subsequent therapy)or discontinue clinic visits an expected average of 12 to 18 weeks.

Patient Population All NSCLC patients with advanced disease (Stage 3B or 4) starting systemic therapy at the Princess Margaret Hospital will be eligible to participate. Inclusion criteria include the physical ability to use the hand-held instrument (adequate vision, manual dexterity), provision of written informed consent, and written fluency in English, French, Italian, Spanish, Portuguese or Chinese. Patients will be excluded if they are unable to complete or understand the assessment process, or if they are receiving concurrent radical radiotherapy.

Physician Information Physicians will be trained in interpretation of the LCSS electronic output data, in order to facilitate interpretation of the different domains of patient well-being, for example pain scores. An endorsement sheet will be printed in addition to the LCSS data, highlighting major changes in quality of life. For example, deterioration in pain control will be highlighted with suggestions to increase or change pain medication, consider radiotherapy and other pain management options, including changing systemic therapy.

Outcomes

Endpoints include palliative care referral rates, duration of systemic therapy, use of supportive interventions and QoL during treatment.

Data on the number of chemotherapy cycles administered, referral to palliative care (including timing), institution of additional supportive treatments, and number of imaging tests ordered will be collected for all patients prospectively. Data on LCSS scores, subsequent therapy, and date of death will also be recorded.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  • Diagnosis of Primary Non Small Cell Lung Cancer
  • Stage 3 or 4 Lung Cancer
  • To receive 1st line Chemotherapy
  • Platinum based chemotherapy or Non Platinum
  • Physical ability to use the hand held device(adequate vision, manual dexterity),
  • ECOG 1-2
  • Written fluency in English, French, Italian, Spanish, Portuguese or Chinese

Exclusion Criteria:

  • Patients will be excluded if they are unable to complete or understand the assessment process,
  • If they are receiving concurrent radical radiotherapy.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01337102

Locations
Canada, Ontario
Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
Sponsors and Collaborators
University Health Network, Toronto
Mount Sinai Hospital, Canada
Investigators
Principal Investigator: NATASHA LEIGHL, MD MSC UNIVERSITY HEALTH NETWORK / PRINCESS MARGARET HOSPITAL
  More Information

No publications provided

Responsible Party: NATASHA LEIGHL, PRINCESS MARGARET HOSPITAL / UNIVERSITY HEALTH NETWORK
ClinicalTrials.gov Identifier: NCT01337102     History of Changes
Other Study ID Numbers: 04-0349-CE
Study First Received: April 5, 2011
Last Updated: December 13, 2011
Health Authority: Canada: Ethics Review Committee

Keywords provided by University Health Network, Toronto:
Lung Cancer
Stage 3b
Stage 4
First Line Chemotherapy Treatment
Quality Of Life
Palliative Care
Randomized
Lung Cancer Scale

Additional relevant MeSH terms:
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms

ClinicalTrials.gov processed this record on October 19, 2014