Addressing the Gaps in Quality of Life: A New Measure for Renal Cell Carcinoma Patients - Cristiane Bergerot
June 15, 2023
Zach Klaassen interviews Cristiane Bergerot to explore health-related quality of life (HRQoL) in renal cell carcinoma patients, with Bergerot asserting that existing measures often overlook relevant aspects. She elaborates on her study, examining patient's perceptions of common HRQoL measures like FKSI-19, EORTC QLQ-C30, and EQ-5D. Involving 147 participants from the US, Brazil, and Europe, the study identifies fatigue, overall quality of life, and emotional symptoms as relevant to patients. Furthermore, patients request additional items relating to treatment-related adverse events, emotional symptoms, and quality of communication with healthcare providers. Bergerot reveals plans to create a new RCC measure that addresses these needs, with clinical trial testing on the horizon. She also explores the potential of wearable devices like smartwatches to monitor physical function, although she highlights concerns about accessibility for older and low-income patients.
Biographies:
Cristiane Bergerot, PhD, MS, BS, City of Hope Comprehensive Cancer Center, Los Angeles, CA, Head of the Psycho-Oncology Department, Centro de Câncer de Brasília (CETTRO), Brasília, Brasil
Zachary Klaassen, MD, MSc, Urologic Oncologist, Assistant Professor Surgery/Urology at the Medical College of Georgia at Augusta University, Georgia Cancer Center
Biographies:
Cristiane Bergerot, PhD, MS, BS, City of Hope Comprehensive Cancer Center, Los Angeles, CA, Head of the Psycho-Oncology Department, Centro de Câncer de Brasília (CETTRO), Brasília, Brasil
Zachary Klaassen, MD, MSc, Urologic Oncologist, Assistant Professor Surgery/Urology at the Medical College of Georgia at Augusta University, Georgia Cancer Center
Read the Full Video Transcript
Zach Klaassen: Hi, my name is Dr. Zach Klaassen. I'm a urologic oncologist at the Georgia Cancer Center in Augusta, Georgia. We are live at ASCO 2023 in Chicago. I'm pleased to be joined today with Dr. Cris Bergerot, who's the head of supportive care at Oncoclínicas in Brazil.
Cristiane Bergerot: Hi, good morning.
Zach Klaassen: Great to have you here.
Cristiane Bergerot: It's a pleasure to be here. Thank you.
Zach Klaassen: So, we're going to discuss an important topic, and basically health related quality of life in patients with renal cell carcinoma. And at least my impression is that, when we talk about HR quality of life, it seems to be pushed to the wayside maybe for RCC versus prostate or bladder. So, just tell us a little bit about health related quality of life in renal cell carcinoma.
Cristiane Bergerot: Yes, I would agree, especially considering the current measures we have nowadays to assess patients quality of life among patients with renal cell carcinoma. These measures usually includes non-relevant items as for example blood in urine for patients with metastatic cancer.
Zach Klaassen: Yeah, absolutely. So we're going to delve into some of your work that you're presenting at ASCO and tell us a little bit about the objective of the work you're presenting today.
Cristiane Bergerot: So in our study, our main goal is to understand patient's perceptions about each items of the most commonly used quality of life measures, including the FKSI-19, the QLQ-C30 and the EQ-5D.
Zach Klaassen: Excellent. And so this was a population from the US and Brazil, if I'm not mistaken, correct?
Cristiane Bergerot: Yeah, we have also included patients from Europe. So we have updated our analysis and we have included 147 patients.
Zach Klaassen: Wonderful. So just walk us through the methods and what you guys were looking at in your work.
Cristiane Bergerot: So this is a prospective study. We have included patients with RCC, especially those with in adjuvant treatment and patients with metastatic disease. And we have asked these patients to rate each item as relevant or non-relevant for all of these three measures.
Zach Klaassen: That's great. So tell us about your results. You looked at each of these three metrics and then the individual items within those metrics, right?
Cristiane Bergerot: Yeah. So we have included 147 patients. 30 patients were diagnosed with localized disease and 117 patients were diagnosed with metastatic disease. And interestingly, a few items were deemed as relevant, especially for patients with localized disease. For example, just five items were rated as relevant by patient in the FQSI19. Just two items in the EORTC QLQ-C30 and one item in the EQ-5D for patients with localized disease.
Zach Klaassen: So two out of 30 items were relevant?
Cristiane Bergerot: Yeah.
Zach Klaassen: Wow.
Cristiane Bergerot: And especially these items focus on fatigue, overall quality of life and emotional symptoms.
Zach Klaassen: I see.
Cristiane Bergerot: And for patients with metastatic disease, 10 items on the FKSI-19, three items in the EORTC and two items in the EQ-5D. And items deemed as relevant includes fatigue, pain, sleep, lack of appetite, and some physical function. For example, the ability to enjoy their life and the ability to work, overall quality of life and also emotional symptoms. And when we asked our patients about additional items that should be included by these questionnaires, they have suggested us to better screen for treatment related adverse events, especially focus on immunotherapy and targeted therapy. Also to better explore emotional symptoms and to include one item related to suicide ideation. And they have also asked us to better ask about access to informations regarding their treatment and also to their diagnosis and prognosis. And also they have suggested us to include some questions about the quality of communications between patients and healthcare providers and how their family are coping with their disease.
Zach Klaassen: That's great. So a lot of great feedback from the patients. So this is basically a great study to then drive the next several years of developing these metrics. So what are you guys doing from a, not even prospective, but just developing those specific metrics that the patients have given feedback about?
Cristiane Bergerot: So we are now developing a new measure, a new RCC measure, focusing on patients with localized and metastatic disease in a joint effort with experts and patients out of the gate.
Zach Klaassen: That's great. So what's your timeline in terms of developing that and hopefully getting prospective data starting to be-
Cristiane Bergerot: So we already validate one of the first measure and we'll also test this measure in a clinical trial.
Zach Klaassen: That's great.
Cristiane Bergerot: In an upcoming clinical trial.
Zach Klaassen: Excellent. And I know in your work you also investigated patients wearing devices that may help with assessing quality of life. And I think you said 58 percent were willing to do it and thought it was helpful. So what are you guys getting from data from these patients specifically?
Cristiane Bergerot: So yeah, we were wondering how this Apple Watch or this kind of smart watch can help us to better measure their quality of life. They seems to like the idea. However, they have suggested us to use this kind of tool with a complimentary role. Because they're afraid that older patient might have some issues with this device and also those patients with lower income won't be able to access.
Zach Klaassen: And what kind of data can you pull from these devices?
Cristiane Bergerot: So some physical function, for example, we are talking a lot nowadays about the importance of physical activities among our patients, especially those in IO therapy. So we'll be able to better understand how our patients are moving through the day and expending some calories. And we can also access how much water they're intake and also if they're doing some mental health exercise, some of the apps that we already have in this kind of device.
Zach Klaassen: I wonder too, if you could, I mean even just on my phone you can tell how long you're sleeping. Are patients sleeping less or too much and are you getting an idea just from that data too?
Cristiane Bergerot: Yeah, this will be great. Yeah.
Zach Klaassen: That's great. No, this is great work. I think you're highlighting RCC patient quality of life, which is excellent. And then I think too, you're looking at it from a localized metastatic and specifically as you mentioned the IO component certainly has a huge, huge opportunity to assess these patients. So give us a couple of take home messages for the audience based on this work.
Cristiane Bergerot: Yeah, I will highlight the need to refine these measures for patients with renal cell carcinoma, especially for those with localized disease. And also I would like to highlight this work that we are doing funded by the KCA, the Kidney Cancer Association, in order to develop a new measure for patients with renal carcinoma.
Zach Klaassen: Outstanding. Well thanks for joining us today Dr. Bergerot.
Cristiane Bergerot: Thank you so much.
Zach Klaassen: I enjoyed the conversation.
Cristiane Bergerot: Thank you. Great.
Zach Klaassen: Hi, my name is Dr. Zach Klaassen. I'm a urologic oncologist at the Georgia Cancer Center in Augusta, Georgia. We are live at ASCO 2023 in Chicago. I'm pleased to be joined today with Dr. Cris Bergerot, who's the head of supportive care at Oncoclínicas in Brazil.
Cristiane Bergerot: Hi, good morning.
Zach Klaassen: Great to have you here.
Cristiane Bergerot: It's a pleasure to be here. Thank you.
Zach Klaassen: So, we're going to discuss an important topic, and basically health related quality of life in patients with renal cell carcinoma. And at least my impression is that, when we talk about HR quality of life, it seems to be pushed to the wayside maybe for RCC versus prostate or bladder. So, just tell us a little bit about health related quality of life in renal cell carcinoma.
Cristiane Bergerot: Yes, I would agree, especially considering the current measures we have nowadays to assess patients quality of life among patients with renal cell carcinoma. These measures usually includes non-relevant items as for example blood in urine for patients with metastatic cancer.
Zach Klaassen: Yeah, absolutely. So we're going to delve into some of your work that you're presenting at ASCO and tell us a little bit about the objective of the work you're presenting today.
Cristiane Bergerot: So in our study, our main goal is to understand patient's perceptions about each items of the most commonly used quality of life measures, including the FKSI-19, the QLQ-C30 and the EQ-5D.
Zach Klaassen: Excellent. And so this was a population from the US and Brazil, if I'm not mistaken, correct?
Cristiane Bergerot: Yeah, we have also included patients from Europe. So we have updated our analysis and we have included 147 patients.
Zach Klaassen: Wonderful. So just walk us through the methods and what you guys were looking at in your work.
Cristiane Bergerot: So this is a prospective study. We have included patients with RCC, especially those with in adjuvant treatment and patients with metastatic disease. And we have asked these patients to rate each item as relevant or non-relevant for all of these three measures.
Zach Klaassen: That's great. So tell us about your results. You looked at each of these three metrics and then the individual items within those metrics, right?
Cristiane Bergerot: Yeah. So we have included 147 patients. 30 patients were diagnosed with localized disease and 117 patients were diagnosed with metastatic disease. And interestingly, a few items were deemed as relevant, especially for patients with localized disease. For example, just five items were rated as relevant by patient in the FQSI19. Just two items in the EORTC QLQ-C30 and one item in the EQ-5D for patients with localized disease.
Zach Klaassen: So two out of 30 items were relevant?
Cristiane Bergerot: Yeah.
Zach Klaassen: Wow.
Cristiane Bergerot: And especially these items focus on fatigue, overall quality of life and emotional symptoms.
Zach Klaassen: I see.
Cristiane Bergerot: And for patients with metastatic disease, 10 items on the FKSI-19, three items in the EORTC and two items in the EQ-5D. And items deemed as relevant includes fatigue, pain, sleep, lack of appetite, and some physical function. For example, the ability to enjoy their life and the ability to work, overall quality of life and also emotional symptoms. And when we asked our patients about additional items that should be included by these questionnaires, they have suggested us to better screen for treatment related adverse events, especially focus on immunotherapy and targeted therapy. Also to better explore emotional symptoms and to include one item related to suicide ideation. And they have also asked us to better ask about access to informations regarding their treatment and also to their diagnosis and prognosis. And also they have suggested us to include some questions about the quality of communications between patients and healthcare providers and how their family are coping with their disease.
Zach Klaassen: That's great. So a lot of great feedback from the patients. So this is basically a great study to then drive the next several years of developing these metrics. So what are you guys doing from a, not even prospective, but just developing those specific metrics that the patients have given feedback about?
Cristiane Bergerot: So we are now developing a new measure, a new RCC measure, focusing on patients with localized and metastatic disease in a joint effort with experts and patients out of the gate.
Zach Klaassen: That's great. So what's your timeline in terms of developing that and hopefully getting prospective data starting to be-
Cristiane Bergerot: So we already validate one of the first measure and we'll also test this measure in a clinical trial.
Zach Klaassen: That's great.
Cristiane Bergerot: In an upcoming clinical trial.
Zach Klaassen: Excellent. And I know in your work you also investigated patients wearing devices that may help with assessing quality of life. And I think you said 58 percent were willing to do it and thought it was helpful. So what are you guys getting from data from these patients specifically?
Cristiane Bergerot: So yeah, we were wondering how this Apple Watch or this kind of smart watch can help us to better measure their quality of life. They seems to like the idea. However, they have suggested us to use this kind of tool with a complimentary role. Because they're afraid that older patient might have some issues with this device and also those patients with lower income won't be able to access.
Zach Klaassen: And what kind of data can you pull from these devices?
Cristiane Bergerot: So some physical function, for example, we are talking a lot nowadays about the importance of physical activities among our patients, especially those in IO therapy. So we'll be able to better understand how our patients are moving through the day and expending some calories. And we can also access how much water they're intake and also if they're doing some mental health exercise, some of the apps that we already have in this kind of device.
Zach Klaassen: I wonder too, if you could, I mean even just on my phone you can tell how long you're sleeping. Are patients sleeping less or too much and are you getting an idea just from that data too?
Cristiane Bergerot: Yeah, this will be great. Yeah.
Zach Klaassen: That's great. No, this is great work. I think you're highlighting RCC patient quality of life, which is excellent. And then I think too, you're looking at it from a localized metastatic and specifically as you mentioned the IO component certainly has a huge, huge opportunity to assess these patients. So give us a couple of take home messages for the audience based on this work.
Cristiane Bergerot: Yeah, I will highlight the need to refine these measures for patients with renal cell carcinoma, especially for those with localized disease. And also I would like to highlight this work that we are doing funded by the KCA, the Kidney Cancer Association, in order to develop a new measure for patients with renal carcinoma.
Zach Klaassen: Outstanding. Well thanks for joining us today Dr. Bergerot.
Cristiane Bergerot: Thank you so much.
Zach Klaassen: I enjoyed the conversation.
Cristiane Bergerot: Thank you. Great.