"Oh when's your treatment ending?" "Never!" The unmet needs of cancer patients treated with immunological, biological and precision therapies: A qualitative interview study

Abstract

Purpose: To explore the unmet supportive care needs of patients with advanced cancer receiving immuno-, biological and precision (IBP) therapies.

Methods: We conducted semi-structured interviews with: (1) adults diagnosed with advanced cancer (lung, colorectal, ovary, breast, renal, melanoma) treated with an IBP therapy (e.g. tyrosine kinase inhibitors, monoclonal antibodies, immunotherapy), for at least one month; (2) healthcare professionals involved in providing hospital care for patients receiving IBP therapies. Interviews were audio-recorded, transcribed and analysed using the Framework Analysis approach; the framework comprised of 11 domains of unmet need: activities of daily living, autonomy, economic, healthcare, information, physical, psychological, role, sexual, social; and an "other" category (to capture data relating to unmet needs that did not fit within pre the-defined domains).

Results: Thirty-one patients and 22 healthcare professionals were interviewed. Ten domains of unmet needs (exceptions: spiritual, other) were evident in the data. Identified unmet needs related to: (1) utilising the IBP therapies (e.g. specific treatment side effects [physical domain], living long-term with uncertainty [psychological], others not understanding why they were not cured [social]; and (2) living with (advanced) cancer (e.g. retiring from work [role], loss of independence [autonomy]).

Conclusions: Patients with advanced cancer being treated with IBP therapies have a diverse range of often inter-related unmet needs. It is vital that healthcare professionals involved in the care of cancer patients using IBP therapies are alert to the unmet needs among this patient group. Interventions and services should be developed to address these needs.

Keywords: Advanced cancer; Biological therapies; Immunotherapy; Unmet needs.