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卵巢癌患者及其家属对新型疫苗和病毒疗法试验的看法。

Ovarian cancer patients' and their family members' perspectives on novel vaccine and virotherapy trials.

作者信息

Radecki Breitkopf Carmen, Ridgeway Jennifer L, Asiedu Gladys B, Carroll Katherine, Tenney Meaghan, Jatoi Aminah

机构信息

Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.

出版信息

Clin Trials. 2016 Dec;13(6):660-664. doi: 10.1177/1740774516654445. Epub 2016 Jun 27.

Abstract

BACKGROUND/AIMS: Some of the most promising avenues of cancer clinical investigation center on immunotherapeutic approaches. These approaches have provided notable gains in cancer therapeutics with recent Food and Drug Administration approvals of agents of this class in several types of cancers, although gains for ovarian cancer lag behind. This study examined perceptions of therapeutic trials including immunotherapy and virotherapy among ovarian cancer patients and their family members.

METHODS

A total of 72 semi-structured qualitative interviews were conducted with 33 patients and 39 family members at two National Cancer Institute-designated comprehensive cancer centers. Eligible patients were diagnosed with epithelial ovarian, primary peritoneal, or fallopian tube carcinoma and had experience with clinical trial conversations; family members were nominated by patients and interviewed separately. Applied thematic analysis was used to understand and interpret the data.

RESULTS

More participants were aware of vaccine trials than virus trials, although more than half had heard of at least one of them. Initial reactions to vaccine trials were generally favorable. For many, childhood experience with vaccines lent a familiar frame of reference. Virus trials elicited more negative initial reactions, including the use of adjectives such as "scary" and "dreadful." Viruses seemed contagious or difficult to control. Increased receptivity to these trials occurred in the context of limited therapeutic options and cancer recurrence. Most participants, including those not immediately drawn to these types of trials, indicated openness to learning more.

CONCLUSION

Although vaccine and viral trials are both immunologically based therapeutic approaches, patients who are offered these trials may perceive their potential benefit and safety quite differently. There is a need to consider terminology, solicit and address "gut reactions," and provide information that enables patients and their family members to better understand the science behind these trials.

摘要

背景/目的:癌症临床研究中一些最具前景的途径集中在免疫治疗方法上。这些方法在癌症治疗方面取得了显著进展,近期美国食品药品监督管理局已批准此类药物用于多种癌症类型,不过卵巢癌的治疗进展相对滞后。本研究调查了卵巢癌患者及其家庭成员对包括免疫疗法和病毒疗法在内的治疗试验的看法。

方法

在两家美国国立癌症研究所指定的综合癌症中心,对33名患者和39名家庭成员进行了共计72次半结构化定性访谈。符合条件的患者被诊断为上皮性卵巢癌、原发性腹膜癌或输卵管癌,且有临床试验相关交流经历;家庭成员由患者提名并单独接受访谈。采用主题分析法来理解和解读数据。

结果

更多参与者知晓疫苗试验而非病毒试验,尽管超过半数的人至少听说过其中一种。对疫苗试验的最初反应总体上是积极的。对许多人来说,童年时期接种疫苗的经历提供了一个熟悉的参照框架。病毒试验引发了更多负面的最初反应,包括使用“可怕”和“恐怖”等形容词。病毒似乎具有传染性或难以控制。在治疗选择有限和癌症复发的情况下,对这些试验的接受度有所提高。大多数参与者,包括那些一开始对这类试验不太感兴趣的人,都表示愿意进一步了解。

结论

尽管疫苗试验和病毒试验都是基于免疫的治疗方法,但接受这些试验的患者可能对其潜在益处和安全性有截然不同的认知。有必要考虑术语,征求并解决“本能反应”,并提供信息,使患者及其家庭成员能够更好地理解这些试验背后的科学原理。

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