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A research study led by Mary Smith, J.D., M.B.A. of the Research Advocacy Network in Plano, Texas, supports the inclusion of patient and consumer perspectives in the design of chemotherapy de-escalation clinical trials. The study was performed to determine public perceptions of chemotherapy de-escalation and how sociodemographic factors might influence these perceptions.

In some cases, anti-cancer medications and medications used to reduce side effects may contribute to the development of some eye problems. Cataracts, dry eye syndrome, and chemo itchy eyes are some examples of eye problems resulting from cancer treatments.

Chemotherapy de-escalation refers to eliminating or reducing one or more drugs from chemotherapy treatment regimens to decrease drug toxicity and improve quality of life without increasing the risk of cancer recurrence or death. This treatment strategy has grown in popularity in clinical research.

A group of thirty women made up of eleven patients diagnosed with HER2+ breast cancer three to five years ago, and nineteen consumers with no history of cancer participated in the study. The women differed in age, race, ethnicity, and educational attainment. They were presented with a description of a large qualitative clinical trial (EA1181 CompassHER2 pCR) studying chemotherapy de-escalation and were asked to share their thoughts on it.

Significant concerns and questions were raised by both patients and consumers. Chief concerns focused on their fears of receiving ineffective treatment and needing to extend treatment duration. Some of the most frequent questions asked related to the rationale behind chemotherapy de-escalation and drug side effects and benefits.

Moreover, the words “de-escalation” and “toxicity” in reference to chemotherapy evoked strong, negative reactions. Patients and consumer motivations for participating in the study included avoiding some chemotherapy and the associated side effects, recovery time, and costs.

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The study concludes that better communication with patients and the general public is needed to foster an understanding of and participation in chemotherapy de-escalation trials. A call to action is made, advocating for the inclusion of patient and consumer voices in clinical trial design [1].


[1] Consumer and patient reactions to trials of chemotherapy reductions reveal an urgent need to name and explain the concept. (2020). https://www.sabcs.org/PortalsSABCS2016/2020%20SABCSFinal%20PDF%20Docs%20111620_All%20PDF%20File%20No%20Embargoed%20Abstracts.pdf?ver=2020-11-17-095626-250