(UK) Oncologists' views about the treatments and care associated with advanced ovarian cancer

Oncologists' views about the treatments and care associated with advanced ovarian cancer

Background

Ovarian cancer treatment depends on histological type, grade and stage of the tumour and general performance status of the patient. Patients may have different expectations about treatment and place different values on outcomes from those of healthcare professionals.

Method

We used an online survey to examine: how UK oncologists manage women with advanced ovarian cancer; available anti-cancer treatments used in practice; oncologists' views on patients' worst symptoms and available supportive interventions. In addition, we are currently interviewing 200 patients about their experiences of treatment and management of their disease in the ADVOCATE study (Advanced Ovarian Cancer: Care & Treatment Experiences).

Results

66 oncologists (44 medical; 22 clinical) completed the survey between October and December 2011. 51 worked in a designated gynaecological cancer centre, 54 were NHS Trust clinicians; 59 trialists and 52 respondents treated >31 advanced disease patients annually. Abdominal pain/swelling was ranked the most common presenting feature (n=46). Carboplatin with paclitaxel (n=56) was the usual 1st line treatment and symptomatic disease progression was main trigger for changes in management. Carboplatin with paclitaxel was the most used for 2nd line (n=39) and subsequent treatments in partially/ platinum sensitive patients (n=25); liposomal doxirubicin for platinum resistant/refractory disease (n=42). The majority (n= 63) conducted routine clinical follow-up, measuring CA125 levels regularly (n=43). Bevacizumab was rarely offered as maintenance therapy (n=3), mainly as not NICE approved (n=49). The minimum PFS gains most oncologists (24/50) felt worthwhile for maintenance therapy was 4-5 months but (26/50) believed patients would consider 3-4 months worthwhile. For OS, 36/60 oncologists indicated 3-4mths as worthwhile; 25/60 felt 1-2mths would be their patients' choice.

Conclusion

These results reflect current practice of trial-active oncologists when treating advanced ovarian cancer. Results from patients' experiences in the ADVOCATE study, will reveal the impact of these treatments and patients' unmet supportive care needs.