I’m presenting the resiliency among older adults receiving lung cancer treatment supportive care study. This was a randomised phase II supportive care clinical trial that tested a novel supportive care intervention that included physical therapy and progressive muscle relaxation in the ROAR intervention group, versus standard of care referral to physical therapy and psychosocial oncology. This was specifically designed for older adults with advanced thoracic malignancies at the Ohio State University.

What was the study design?

This was a phase II randomised study and in the intervention group older adults received physical therapy, both in person and virtually, and they received it for up to 12 sessions, versus the standard of care group just had a standard referral to physical therapy at a location of their choosing. What we found is that with this novel supportive care intervention we were able to improve physical functioning, measured by the short physical performance battery, significantly in the intervention group and we decreased fatigue by about 20% in the intervention group versus standard of care.

In the standard of care group a smaller proportion of patients actually participated with physical therapy, whereas 100% of the participants in the intervention group were exposed to some level of physical therapy. So not only did we meet our feasibility endpoint, which was having over 60% of participants have at least eight sessions of physical therapy, but we were also significantly able to improve physical functioning and decrease fatigue for these older adults with stage 4 thoracic malignancies. The majority were receiving treatment, they were actively on treatment, but some were also on a treatment break. So we were able to help people feel better but also objectively improve their physical functioning as well.

What is the significance of these results, and what is next for this study?

This was really one of the first studies in the United States to meet feasibility to improve physical functioning and really improve access for older adults. Over 30% of our patient population actually lived in rural zip codes in Ohio and the surrounding area. So we were able to significantly improve access but also really bring supportive care to older adults with advanced thoracic cancers. So not only non-small cell but also patients with extensive stage small cell and mesothelioma were able to participate in this study.

I feel often in these supportive care interventions older adults are less likely to participate because of access issues. So we were really able to bring the intervention to the patient rather than requiring the patient to come to the medical centre for multiple extra trips. So we were really able to design and implement this supportive care intervention that was helpful but also didn’t increase treatment burden for older adults and we were able to see the benefits of it.

So the next step is to conduct an even larger study comparing it to what’s called an attention control and then eventually to branch out to other sites across the United States to try to disseminate this intervention across the United States to improve access for older adults so that they feel better. Even though they have a stage 4 lung cancer diagnosis, we know that we are able to do supportive care interventions that aren’t overly burdensome to help them live well.

Is there anything else you would like to add?

It is important to know that older adults are able to participate and want to participate, even if they have an advanced cancer. Even though the life expectancy often, even for patients with stage 4, is improving so we have to rethink survivorship care. Even if they may not live for years and years and years, we are able to intervene in a meaningful way so that they can feel as good as they can feel, regardless of how long they have to live. Because often when we’re diagnosed with an advanced cancer a lot of us say, ‘Well, why bother? Why should I do anything extra?’ But we can improve how people feel, even when they’re facing a stage 4 cancer diagnosis.