The landscape of metastatic melanoma (MM) treatment has shifted with the use of immune checkpoint inhibitors, anti PD-1 and anti-CTLA-4 agents. Patients experience improved survival on treatment at the expense of undesirable side effects. A comprehensive supportive care assessment and tailored support program was explored in a feasibility study.
To explore the experience of patients with MM receiving systemic treatment with pembrolizumab.
A pre-post-test feasibility study was conducted over 9 weeks. Qualitative semi-structured interviews were conducted. Interviews were audio-recorded and transcribed then managed in NVivo 11. Transcripts were analysed using interpretative phenomenological analysis with themes developed iteratively and inductively.
A total of 28 participants were recruited, 26 completed the qualitative interview. Three wide-ranging themes were identified representing the participants’ principal concerns. These themes were: 1) living and coping within a spectrum of uncertainty, 2) navigating the immunotherapy treatment experience, and 3) the experience and subjective benefits of supportive care. These interconnected concerns were not limited to the duration of the study; rather, participants described the temporal impacts of the disease, its treatments, and adverse effects.
The supportive care intervention was experienced as professional, friendly, and genuinely interested in participant wellbeing. Personalised holistic advice was valued by participants, particularly the explanation of symptoms and management strategies.
Side effects from pembrolizumab are present but reported to be minimal and manageable by this population. A supportive care intervention was valued and may add to participant wellbeing and ability to manage side effects.