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Palliative Care Integration in Pediatric Oncology Phase 1 Clinical Trials

8 luglio 2026 aggiornato da: Andrea Cuviello, Phoenix Children's Hospital

Although cure rates continue to rise, one in five children with cancer still die from their disease, so new therapies are urgently needed. Most advances in childhood cancer treatments have originated through clinical trial research and new therapies must be tested in early phase clinical trials. Phase 1 clinical trials are designed to focus mainly on determining whether a drug is safe, and less on how well it cures a disease. These trials may offer patients and families hope when no other options are available to treat their cancer. However, patients in these trials may also experience treatment-related side effects and earlier death. Patients and families enrolled in phase 1 clinical trials often experience increased levels of distress. This distress may result from physical effects of the disease or treatments, or from worry, sadness, or confusion when making difficult decisions related to care or end-of-life.

Pediatric palliative care (PPC) is a field that aims to ease physical, psychological, emotional, and spiritual suffering and may be beneficial to patients and families enrolling in phase 1 clinical trials. Over the past decade, PPC has been shown to improve quality of life, patient and family healthcare understanding and satisfaction, communication, shared-medical decision making, advanced care planning, and healthcare cost savings. Despite evidence showing the benefits of PPC, it is not used consistently in pediatric oncology care, particularly in the setting of early phase clinical trials. Including PPC experts is a proven way to improve access to specialty care for vulnerable populations. In this application, investigators propose a study to test the feasibility, acceptability, and potential impact of including PPC consultation for pediatric cancer patients and their families during their enrollment in phase 1 clinical trials.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The proposed single-arm pilot study will use a prospective, longitudinal design conducted across three urban, tertiary care hospitals offering pediatric oncology phase 1 clinical trials (Phoenix Children's, St. Jude Children's Research Hospital, and the National Institutes of Health). These centers were chosen for their geographical diversity and variability in infrastructure and PPC resources to allow for generalizability of findings.

Aim 1: To assess the feasibility of integrating PPC consultation during eligibility screening for pediatric oncology patients enrolling in a phase 1 clinical trial.

Measures: Feasibility of the intervention (PPC consultation) will be assessed using the Feasibility of Intervention Measure (FIM), a high quality, 4-item implementation indicator, to be completed by caregivers of pediatric oncology patients (with or without patient, if patient aged ≥12 years) enrolling in phase 1 clinical trials and their respective oncologists. Additional measures will assess recruitment (total patients/caregivers screened, percent of patients/caregivers eligible to participate in the study, percent of patients/caregivers who assent/consent to study participation), and adherence (the proportion of study assessments completed, and the length of time required to complete study assessments).

Hypothesis: Integration of a PPC consultation at eligibility screening for pediatric oncology patients enrolling in a phase 1 clinical trial will be feasible, meeting the following targets: mean FIM score of ≥ 3 (coded 1-5) for > 50% of caregivers and oncology providers; enrollment: ≥ 70% of eligible patients/caregivers will assent/consent; adherence: ≥ 75% of enrolled participants will complete all PPC study assessments as planned. These target estimates are extrapolated from our preliminary work with this patient population.

Aim 2: To evaluate the acceptability of a PPC consultation with oncologists and caregivers of pediatric patients with cancer during phase 1 clinical trial enrollment.

Measures: Acceptability of the intervention, (PPC consultation) will be assessed using the Acceptability of Intervention Measure (AIM), a 4-item tool administered to caregivers of patients enrolled in phase 1 clinical trials (+/- patients if ≥ 12 years) and their respective oncologists. Additional measures will assess attrition (the proportion of enrolled patients lost to follow-up/withdrawal).

Hypothesis: Integration of a PPC consultation at eligibility screening for pediatric oncology patients enrolling in a phase 1 clinical trial will be acceptable, with a mean AIM score of ≥ 3 (coded 1-5) for > 70% of caregivers and oncology providers.

Aim 3: To assess patient/caregiver perceptions of the impact of a PPC consultation on quality of life and facilitators/barriers to PPC consultation integration into the standard of care for pediatric patients with cancer enrolling on phase 1 clinical trials. Methods: Investigators will conduct semi-structured qualitative interviews with caregivers (+/- patients if ≥ 12 years) enrolled in phase 1 clinical trials following the completion of a PPC consult by asking: What was the impact of a PPC consultation at the time of enrollment in a phase 1 clinical trial on the quality of life of the participant? These interviews will also explore barriers and facilitators to PPC consultation at this timepoint. Investigators will thematically analyze the audio-recorded interviews. Investigators will also administer the PROMIS-Pediatric Profile-2510, a validated tool for caregivers, children, and adolescents (≥ 8 years), to assess the potential impact of the intervention on health-related quality of life.

Tipo di studio

Interventistico

Iscrizione (Stimato)

30

Fase

  • Prima fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Stati Uniti
    • Arizona
      • Phoenix, Arizona, Stati Uniti, 85016
    • Maryland
      • Bethesda, Maryland, Stati Uniti, 20814
        • Non ancora reclutamento
        • National Institutes of Health
        • Contatto:
    • Tennessee
      • Memphis, Tennessee, Stati Uniti, 38105
        • Non ancora reclutamento
        • St. Jude Children's Research Hospital
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Bambino
  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Patients (aged 0-25 years) diagnosed with cancer and undergoing evaluation for enrollment in a phase 1 trial, their caregivers, as well as their primary treating oncologist are eligible for study participation.

Exclusion Criteria:

  • Previous palliative care exposure

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Terapia di supporto
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Pediatric Palliative Care Consultation
Formal PPC consultation will be completed by a subspeciality-trained PPC physician at each participating site for all study participants during the eligibility screening period for the phase 1 trial. Subsequent standard of care PPC follow-up visits will occur every 2-4 weeks to allow for variations in phase 1 trial structure.
Comportamentale: Pediatric Palliative Care Consultation
Formal PPC consultation will be completed by a subspeciality-trained PPC physician at each participating site for all study participants during the eligibility screening period for the phase 1 trial. Subsequent standard of care PPC follow-up visits will occur every 2-4 weeks to allow for variations in phase 1 trial structure.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Feasibility
Lasso di tempo: 2 years
Feasibility will be defined as a mean FIM score of ≥ 3 (coded 1-5) for > 50% of caregivers and oncology providers; enrollment: ≥ 70% of eligible patients/caregivers will assent/consent; adherence: ≥ 75% of enrolled participants will complete all PPC study assessments as planned. Themes identified from qualitative findings, specifically from caregivers/patients' experiences with the PC team (either positive or negative) will be compared alongside quantitative data in a matrix to assess for overlap or variances in findings related to intervention feasibility, acceptability, and impact.
2 years
Acceptability
Lasso di tempo: two years
Acceptability will be defined as a mean AIM score of ≥ 3 (coded 1-5) for > 70% of caregivers and oncology providers. Themes identified from qualitative findings, specifically from caregivers/patients' experiences with the PC team (either positive or negative) will be compared alongside quantitative data in a matrix to assess for overlap or variances in findings related to intervention feasibility, acceptability, and impact.
two years

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Barriers and Facilitators to Palliative Care Integration
Lasso di tempo: two years
To assess participants' perceptions of how PPC integration at the time of phase 1 trial enrollment impacted quality of life and facilitators/barriers to PPC consultation, investigators will conduct a one-time, semi-structured interview with the caregiver/patient (> 12 years) within 1 week following the third PPC visit or phase 1 study completion.
two years
Impact on quality of life
Lasso di tempo: two years

Investigators will administer the PROMIS-Pediatric Profile-25 survey (Patient-Reported Outcomes Measurement Information System) at baseline and within 1 week following the third PPC visit or phase 1 study completion. Patients' reported outcomes in the context of the PPC intervention will be assessed, including mobility, anxiety, depression, fatigue, peer relationships, and pain interference/intensity. This tool was validated for adolescents aged ≥ 8 years, translated into several languages for non-English-speaking participants, and requires 5-10 minutes for completion.

PROMIS results are always reported on a T-score metric, which compares participants' results to a reference population (usually the U.S. general population). The greater the score, the more severe the symptoms (i.e. Less than 55: Normal or better-than-average; 55 - 60: Mild symptoms; 60 - 70: Moderate symptoms; Greater than 70: Severe symptoms).
two years

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Phoenix Children's Hospital

Collaboratori

National Institute on Aging (NIA)

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

6 luglio 2026

Completamento primario (Stimato)

14 gennaio 2028

Completamento dello studio (Stimato)

14 giugno 2028

Date di iscrizione allo studio

Primo inviato

2 luglio 2026

Primo inviato che soddisfa i criteri di controllo qualità

8 luglio 2026

Primo Inserito (Effettivo)

10 luglio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

10 luglio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

8 luglio 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • 26-101
  • U54AG093230 (Sovvenzione/contratto NIH degli Stati Uniti)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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