Stage III Ovarian Cancer Clinical Trial
Official title:
Ovarian Cancer Patient-Centered Decision Aid
The objective of this study is to develop and test a new decision aid -named Patient Centered
Outcome Aid (PCOA)-that will allow patients to assimilate information and identify trade-offs
about the impact of IP/IV therapy versus IV-only therapy on their QOL and survival, based on
their own preferences and personal clinical characteristics, described in terms that are
meaningful to them. To accomplish this, the investigators will 1)develop the PCOA, a patient-
and provider-friendly decision aid and 2)test the effectiveness of PCOA through a randomized
controlled trial (RCT).
The investigators hypothesize that PCOA will be significantly better than usual care,
resulting in patients reporting more satisfaction with their treatment decision, less
decision regret, better quality of life, and more satisfaction with their care compared with
similar patients not having access to PCOA. If these hypotheses are substantiated, patients
and providers will have an improved model for communication and decision making, leading to
better patient outcomes.
Ovarian cancer is typically diagnosed at an advanced stage and carries the highest fatality-to-case ratio of all gynecologic malignancies diagnosed in the United States. Arguably the most effective treatment regimen to date is provided through intraperitoneal (IP) chemotherapy delivery, together with intravenous (IV) chemotherapy, which in the most recent phase III randomized trial conferred the longest median survival (65.6 months) ever reported in advanced ovarian cancer, compared to 49.7 months in the IV-only treatment arm. However, during active treatment, patients randomized to the IP therapy group reported significantly worse quality of life (QOL), and more treatment-related toxicities. In short, women are less likely to die if they receive an IP component to their chemotherapy, a finding that was underscored by an NCI Clinical Alert. However, there may be greater toxicity with IP treatment. The tradeoff between short-term reduced QOL and longer survival is difficult for patients to understand and then incorporate meaningfully into their decision-making process. In fact, for reasons that are not entirely clear, many patients are not offered IP therapy. Patient-centered care requires that they be given the opportunity to participate in treatment decision-making. ;
Status | Clinical Trial | Phase | |
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Completed |
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