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. 2021 Feb 25:15:453-465.
doi: 10.2147/PPA.S292462. eCollection 2021.

Cancer Patients' Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Robert S Epstein  1 , Upal K Basu Roy  2 , Matti Aapro  3 , Tehseen Salimi  4 , Donald Moran  4 , JoAnn Krenitsky  1 , Megan L Leone-Perkins  5 , Cynthia Girman  6 , Courtney Schlusser  7 , Jeffrey Crawford  8
Affiliations

Cancer Patients' Perspectives and Experiences of Chemotherapy-Induced Myelosuppression and Its Impact on Daily Life

Robert S Epstein et al. Patient Prefer Adherence. .

Abstract

Purpose: To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the "patient voice" describing how CIM impacts their daily lives.

Participants and methods: Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: "In your own words, please describe how side effects from myelosuppression have impacted your life."

Results: Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1-10 scale of "bothersomeness"). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24-43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family.

Conclusion: Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.

Keywords: cancer; chemotherapy; myelosuppression; patient burden; quality of life; real world.

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Conflict of interest statement

Robert S. Epstein is a consultant for G1 Therapeutics, Inc., and serves on the board for Decipher Biosciences, Fate Therapeutics, Illumina, Proteus Digital, and Veracyte. Upal K. Basu Roy has received research funding unrelated to this project from Astra Zeneca, Bristol Myers Squibb Foundation, and Merck. Matti Aapro has served as a consultant for Amgen, Bristol Myers Squibb, Daiichi Sankyo, Fresenius Kabi, G1 Therapeutics, Inc., Genomic Health, Helsinn Healthcare, Merck KGaA, Merck, Novartis, Pfizer, Pierre Fabre, Roche, Sandoz, Tesaro, and Vifor Pharma; is on the speakers’ bureau for Accord Research, Amgen, Biocon, Dr Reed, Genomic Health, Helsinn Healthcare, Mundipharma, Novartis, Pierre Fabre, Pfizer, Roche, Sandoz, Taiho Pharmaceutical, Tesaro, and Vifor Pharma; and has received research funding from Helsinn Healthcare, Novartis, Pierre Fabre, and Sandoz. Tehseen Salimi was an employee of G1 Therapeutics, Inc., at the time of study completion, and is currently an employee of Taiho Oncology, Inc. Donald Moran is an employed consultant for G1 Therapeutics, Inc. JoAnn Krenitsky is a consultant for G1 Therapeutics, Inc. Megan L. Leone-Perkins is a consultant for HealthiVibe, a division of Corrona LLC. Cynthia Girman and Courtney Schlusser are consultants for G1 Therapeutics, Inc., and other pharmaceutical companies through CERobs Consulting and Epstein Health. Jeffrey Crawford has served as an advisor to Amgen, Coherus, G1 Therapeutics, Inc., and Pfizer. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Participant-reported impact of the side effects of CIM on daily living.
Figure 2
Figure 2
What oncology patients say about the burden of CIM and its side effects. Illustrative comments by each of the eight key themes are shown.
See this image and copyright information in PMC

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Grants and funding

This study was funded by G1 Therapeutics, Inc. (Research Triangle Park, NC, USA). The study sponsor was involved in study design; collection, analysis and interpretation of data; writing the report, and in the decision to submit the article for publication.

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