Hutton Brian, Morretto Patricia, Emmenegger Urban, Mazzarello Sasha, Kuchuk Iryna, Addison Christina L, Crawley Freya, Canil Christine, Malone Shawn, Berry Scott, Fergusson Dean, Clemons Mark
Ottawa Hospital Research Institute, Ottawa, ON, Canada; University of Ottawa Department of Epidemiology and Community Medicine, Ottawa, ON, Canada.
Ottawa Hospital Cancer Centre and University of Ottawa, Department of Medicine, Ottawa Canada, Ottawa, ON, Canada K1H 8L6.
J Bone Oncol. 2013 Jun 21;2(3):105-9. doi: 10.1016/j.jbo.2013.05.002. eCollection 2013 Sep.
In order to design studies assessing the optimal use of bone-targeted agents (BTAs) patient input is clearly desirable.
Patients who were receiving a BTA for metastatic prostate or breast cancer were surveyed at two Canadian cancer centres. Statistical analysis of respondent data was performed to establish relevant proportions of patient responses.
Responses were received from 141 patients, 76 (53.9%) with prostate cancer and 65 (46.1%) with breast cancer. Duration of BTA use was <3 months (15.9%) to >24 months (35.2%). Patients were uncertain how long they would remain on a BTA. While most felt their BTA was given to reduce the chance of bone fractures (77%), 52% thought it would slow tumour growth. Prostate patients were more likely to receive denosumab and breast cancer patients, pamidronate. There was more variability in the dosing interval for breast cancer patients. Given a choice, most patients (49-57%) would prefer injection therapy to oral therapy (21-23%). Most patients (58-64%) were interested in enrolling in clinical trials of de-escalated therapy.
While there were clear differences in the types of BTAs patients received, our survey showed similarity for both prostate and breast cancer patients with respect to their perceptions of the goals of therapy. Patients were interested in participating in trials of de-escalated therapy. However, given that patients receive a range of agents for varying periods of time and in different locations (e.g. hospital vs. home), the design of future trials will need to be pragmatic to reflect this.
为了设计评估骨靶向药物（BTAs）最佳使用方法的研究，显然需要患者的参与。
在加拿大的两个癌症中心对正在接受BTAs治疗转移性前列腺癌或乳腺癌的患者进行了调查。对受访者数据进行统计分析，以确定患者反应的相关比例。
共收到141名患者的回复，其中76名（53.9%）患有前列腺癌，65名（46.1%）患有乳腺癌。BTAs的使用时间从<3个月（15.9%）到>24个月（35.2%）不等。患者不确定自己会使用BTAs多长时间。虽然大多数人认为他们使用BTAs是为了降低骨折的几率（77%），但52%的人认为它会减缓肿瘤生长。前列腺癌患者更有可能接受地诺单抗，乳腺癌患者更有可能接受帕米膦酸。乳腺癌患者的给药间隔更具变异性。如果可以选择，大多数患者（49 - 57%）更喜欢注射治疗而非口服治疗（21 - 23%）。大多数患者（58 - 64%）有兴趣参加降阶梯治疗的临床试验。
虽然患者接受的BTAs类型存在明显差异，但我们的调查显示，前列腺癌和乳腺癌患者在对治疗目标的认知方面具有相似性。患者有兴趣参与降阶梯治疗的试验。然而，鉴于患者在不同时间、不同地点（如医院与家中）接受一系列不同的药物治疗，未来试验的设计需要务实以反映这一情况。
