NHMRC Clinical Trials Centre, The University of Sydney, 92-94 Parramatta Rd, Camperdown, NSW, 2050, Australia.
School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Patient. 2021 Sep;14(5):635-647. doi: 10.1007/s40271-021-00507-1. Epub 2021 Mar 24.
Adjuvant immunotherapy is a new treatment paradigm for adults with resected stage 3 melanoma. However, therapy can lead to long-term adverse health impacts, making immunotherapy decisions difficult. This study aimed to explore patients and their partners' views when considering whether to commence adjuvant immunotherapy.
Focus groups and in-depth interviews were conducted among adults with resected stage 3 melanoma and their partners between August 2019 and April 2020. Factors important to adjuvant immunotherapy decision making were explored. Recruitment continued until data saturation, with thematic analysis performed.
Thirty-six participants were recruited across two cohorts, including 24 patients (mean age 65 years, 71% male), and 12 partners (mean age 69 years, 75% female). Twenty-two patients (92%) received adjuvant immunotherapy, two (8%) declined. Five patients (21%) ceased treatment early because of toxicity. Five themes about adjuvant immunotherapy were common to all participants: (1) life and death; (2) perceived risks and benefits; (3) seeking information; (4) healthcare team relationship; and (5) immunotherapy treatment considerations. Prolonging life was the primary consideration, with secondary concerns about treatment burden, timing, costs and efficacy.
This information can be used by clinicians to support melanoma treatment decision making.
辅助免疫疗法是一种治疗 3 期黑色素瘤成人患者的新方法。然而，这种治疗方法可能会导致长期的健康影响，从而使免疫疗法的决策变得困难。本研究旨在探讨患者及其伴侣在考虑是否开始辅助免疫治疗时的观点。
2019 年 8 月至 2020 年 4 月，对已接受 3 期黑色素瘤切除术的成人患者及其伴侣进行了焦点小组和深入访谈。探讨了对辅助免疫治疗决策有重要影响的因素。在达到数据饱和时继续招募参与者，并进行主题分析。
在两个队列中招募了 36 名参与者，包括 24 名患者（平均年龄 65 岁，71%为男性）和 12 名伴侣（平均年龄 69 岁，75%为女性）。22 名患者（92%）接受了辅助免疫治疗，2 名（8%）拒绝了。由于毒性，有 5 名患者（21%）早期停止了治疗。所有参与者都有五个共同的关于辅助免疫治疗的主题：（1）生死；（2）感知到的风险和益处；（3）寻求信息；（4）医患关系；和（5）免疫治疗的考虑因素。延长生命是主要考虑因素，其次是治疗负担、时机、成本和疗效。
这些信息可以为临床医生提供黑色素瘤治疗决策支持。
