‘Symptom science’ research effort aims to optimize quality of life, minimize toxicities
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Oregon Health & Science University has implemented a “symptom science” clinical research program designed to mitigate toxicities and improve quality of life for people with cancer.
The Symptom Science Research Group — a multidisciplinary team of researchers and trainees specializing in oncology, palliative care, basic science, nursing, exercise, and biostatistics — conducts clinical studies on symptoms and treatment-related toxicities associated with various cancer types.
The goal is to better understand the pathophysiology of symptoms, discover biomarkers that may predict toxicity, and improve patients’ quality of life.
“Symptom science is research focused on the patient, not the cancer, to optimize how patients feel during their treatment,” Eric Roeland, MD, FASCO, FAAHPM, director of the symptom science program at OHSU Knight Cancer Institute, told Healio. “It’s focused on minimizing toxicity and optimizing the delivery of cancer therapy.”
Few NCI-designated cancer centers have research programs dedicated to symptom science, Roeland said.
“Sadly, this has not been a priority across most cancer centers,” he said. “Oftentimes, the focus is on treatment trials, but I would argue that if we can optimize the side effect profile [and] the symptom experience, we can improve clinical outcomes in a way that aligns with cancer treatment trials.”
OHSU’s research program — housed at Knight Cancer Institute — has opened seven clinical trials over 2 years. Focus areas include immunotherapy-related adverse events, tyrosine kinase-inhibitor-associated diarrhea, and a monoclonal antibody that targets a key inflammatory mediator that causes cancer cachexia. Additional trials are planned, including studies focused on cancer cachexia, hot flashes and chemotherapy-induced peripheral neuropathy.
“Validated patient-reported outcomes are a key endpoint of these types of trials,” Roeland said. “Oncology trials primarily focus on time-to-event analyses, such as time to progression, progression-free survival or overall survival. These studies will use an endpoint of patient-reported quality of life, which is rigorously vetted. The FDA is now requiring that these types of outcomes be included as key secondary endpoints for all our treatment-related trials, as well.”
This type of research is critical, Roeland said, given there are about 19 million cancer survivors in the United States. That number is projected to reach 26 million by 2040, according to NCI.
“As we continue to develop highly effective drugs to treat cancer, we also need to prioritize that these treatments don’t have long-term side effects that limit the quality of life and independence of cancer survivors,” Roeland said. “It’s important that we co-develop strategies to minimize toxicities because patients are living with these effects, and they have equal importance in the development of drugs.”
Roeland said he hopes to see OHSU’s program expand and would also like to see greater prioritization of symptom science research elsewhere.
“I hope that the NCI realizes that categorizing these types of trials as ‘non-interventional’ leads to them not being prioritized in the same way as cancer-directed studies,” Roeland told Healio. “Patients, patient advocates, and caregivers believe that treatment-related toxicities and evidence-based approaches to minimize side effects should be a major priority.”
References:
- Tonorezos E, et al. J Natl Cancer Inst. 2024;doi:10.1093/jnci/djae135.
- ‘Symptom Science’ aims to ease the burden of cancer treatment (press release). Available at: https://news.ohsu.edu/2024/04/09/symptom-science-aims-to-ease-burden-of-cancer-treatment. Published April 9, 2024. Accessed Aug. 7, 2024.
For more information:
Eric J. Roeland, MD, FASCO, FAAHPM, can be reached at roeland@ohsu.edu.
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