Cella D, Wen PY, Ervin C, Vallow S, Gilloteau I, DeMuro C, Mordin M, Agostinho AC, Dine J. Understanding the patient experience and treatment benefits in patients with non–small-cell lung cancer with brain metastasis. Cancer Med. 2023 Jun 12;12(12):13637-48. doi: 10.1002/cam4.5975

BACKGROUND: Despite the high prevalence of brain metastases (BM) secondary to non–small-cell lung cancer (NSCLC) (NSCLC/BM), patients’ experiences (symptoms and impacts) are not fully understood. This study sought to understand the patient experience with NSCLC/BM and identify a patient-reported outcome (PRO) measure fit to capture the most important NSCLC/BM symptoms and impacts.

METHODS: A targeted literature review was completed; the National Comprehensive Cancer Network (NCCN)/Functional Assessment of Cancer Therapy–Brain Symptom Index, 24-item version (NFBrSI-24) was identified as a relevant measure that assessed the core symptoms and impacts associated with NSCLC/BM. Qualitative interviews composed of concept elicitation and cognitive debriefing with oncologists (n=3) and adult patients (n=16) with NSCLC/BM were conducted to confirm the content validity and evaluate the relevance and appropriateness of the NFBrSI-24 for this condition.

RESULTS: The NSCLC/BM symptoms and impacts identified in the literature and reported by oncologists and patients were consistent and captured in the NFBr-SI-24. Study participants reported significant burden associated with the symptoms (commonly fatigue, headache) and impacts of NSCLC/BM. Participants indicated that the NFBrSI-24 captured their most salient experiences with NSCLC/BM and that symptom improvement or a delay in progression, as measured by the NFBrSI-24, would be meaningful. During the cognitive debriefing, participants generally indicated that the NFBrSI-24 was comprehensive, easy to understand/answer, and assessed symptoms they considered most important to treat.

CONCLUSIONS: These results suggest that the NFBrSI-24 adequately captures an appropriate measure of NSCLC/BM symptoms and impact.

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