Contact Days Associated With Cancer Treatments in the CCTG LY.12 Trial

Abstract

Background When cancer treatments have similar oncologic outcomes, the number of days with in-person healthcare contact (“”contact days’’) can help contextualize expected time use with each treatment. We assessed contact days in a completed randomized clinical trial. Patients and Methods We conducted a secondary analysis of the CCTG LY.12 RCT that evaluated 2-3 cycles of gemcitabine, dexamethasone, and cisplatin (GDP) vs. dexamethasone, cytarabine, and cisplatin (DHAP) in 619 patients with relapsed/refractory lymphoma prior to stem cell transplant. Primary analyses reported similar response rates and survival. We calculated patient-level “contact days” by analyzing trial forms. The study period was from assignment to progression or transplant. Days without healthcare contact were considered “home days’’. We compared measures of contact days across arms. Results The study period was longer in the GDP arm (median 50, vs. 47 days, P = .007). Contact days were comparable in both arms (median 18 vs 19, P = 0.79), but home days were higher in the GDP arm (median 33 vs 28, P < .001). The proportion of contact days was lower in the GDP arm (34%, vs. 38%, P = .009). The GDP arm experienced more contact days related to planned outpatient chemotherapy (median, 10 vs. 8 days), but the DHAP arm experienced many more inpatient contact days (median, 11 vs. 0 days). Conclusions Measures of time use, such as contact days, can be extracted from RCTs. In LY.12, despite comparable oncologic outcomes, GDP was associated with fewer contact days. Such information can guide decision-making for patients with hematological cancers, who already face significant healthcare contact.

Home time among older adults with acute myeloid leukemia by therapy intensity

“…HT for patients with hematologic malignancies has otherwise not been routinely reported outside of the context of hospice care, 9 although Gupta and colleagues recently described home days versus contact days among participants in an international clinical trial for relapsed/refractory non-Hodgkin lymphomas. 10 Our study has limitations. First, it was conducted at a single center with a relatively small sample, which may limit its generalizability.…”