Dr Ackroyd on the Assessment of Time Toxicity in Advanced/Recurrent Endometrial Cancer

Sarah Ackroyd, MD, MPH fellow, gynecologic oncology, University of Chicago Medical Center, discusses the rationale and key results from a study of time-related treatment burden in patients receiving treatment for advanced, recurrent endometrial cancer.

In the field of gynecologic cancer, there has been increasing emphasis on the value of patient-reported outcomes for guiding treatment decisions, Ackroyd begins. Accordingly, it is important to consider and discuss a patient's financial toxicity, she says. However, there is currently no standard measurement or understanding of a patient's time-related burden while on treatment, or how this impacts their financial wellbeing, Ackroyd explains.

Researchers proposed a study to measure treatment-related time burden, evaluate this time toxicity for different regimens, and correlate this measure with patients' quality of life (QOL), Ackroyd states. The study evaluated patients with advanced/recurrent endometrial cancer of varying histology, who received comprehensive care at a single institution or health system. Time toxicity was defined as the total number of days spent at a healthcare facility divided by the number of days on treatment. ​​ Data were collected using self-reported demographics, qualitative structured interviews on decision preference, a QOL survey, and chart review to measure time toxicity. 

Initial results from the study were presented at the 2023 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, and showed that patients with advanced recurrent endometrial cancer spent 15% of their time on treatment engaging with healthcare, Ackroyd says. Patients who received radiation therapy had the largest time-related toxicity measure, followed by cytotoxic chemotherapy, clinical trials, immunotherapy, and hormone therapy. 

Moreover, QOL decreased as the percentage of time spent at the healthcare facility increased across all patient cohorts, Ackroyd notes. This finding could be attributed to several risk factors or time-related complications, including the presence of severity of comorbidities, Ackroyd concludes.