Format

Send to

Choose Destination
EBioMedicine. 2018 Nov;37:205-213. doi: 10.1016/j.ebiom.2018.10.060. Epub 2018 Oct 29.

The Avatar Acceptability Study: Survivor, Parent and Community Willingness to Use Patient-Derived Xenografts to Personalize Cancer Care.

Author information

1
Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia. Electronic address: c.wakefield@unsw.edu.au.
2
Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia.
3
Hereditary Cancer Clinic, Department of Medical Oncology, Prince of Wales Hospital, NSW, Australia.; Prince of Wales Clinical School, Faculty of Medicine, Prince of Wales Hospital, NSW, Australia.
4
Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
5
Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia; Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.
6
School of Women's and Children's Health, UNSW, Sydney, NSW, Australia; Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Abstract

BACKGROUND:

Using patient-derived xenografts (PDXs) to assess chemosensitivity to anti-cancer agents in real-time may improve cancer care by enabling individualized clinical decision-making. However, it is unknown whether this new approach will be met with acceptance by patients, family and community.

METHODS:

We used a cross-sectional structured survey to investigate PDX acceptability with 1550 individuals across Australia and New Zealand (648 survivors of adult and childhood cancer, versus 650 community comparisons; and 48 parents of childhood cancer survivors versus 204 community parents). We identified factors influencing willingness-to-use PDXs, willingness-to-pay, maximum acceptable wait-time, and maximum acceptable number of mice used per patient.

FINDINGS:

PDXs were highly acceptable: >80% of those affected by cancer felt the potential advantages of PDXs outweighed the disadvantages (community participants: 68%). Survivors' and survivors' parents' most highly endorsed advantage was 'increased chance of survival'. 'Harm to animals' was the least endorsed disadvantage for all groups. Cancer survivors were more willing to use PDXs than community comparisons [p < ·001]. Survivors and survivors' parents were willing to pay more [p < ·001; p = ∙004 respectively], wait longer for results [p = ·03; p = ∙01], and use more mice [p = ·01; p < ∙001] than community comparisons. Male survivors found PDXs more acceptable [p = ·01] and were willing to pay more [p < ·001] than female survivors. Survivors with higher incomes found PDXs more acceptable [p = ·002] and were willing to pay more [p < ·001] than survivors with lower incomes. Mothers found PDXs more acceptable [p = ·04] but were less willing to wait [p = ·02] than fathers.

INTERPRETATION:

We found significant attitudinal support for PDX-guided cancer care. Willingness-to-pay and maximum acceptable number of mice align well with likely future usage. Maximum acceptable wait-times were lower than is currently achievable, highlighting an important area for future patient education until technology has caught up.

KEYWORDS:

Acceptability; Informed consent; Oncology; Patient derived xenograft; Pediatric cancer; Willingness-to-pay

PMID:
30385234
PMCID:
PMC6286267
DOI:
10.1016/j.ebiom.2018.10.060
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center