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Berufsbezogene Beratung im Rahmen der Cancer-Rehabilitation-Support-by-Cancer-Counseling-Centers(CARES)-Studie

Abstract (Expand)

**Hintergrund** Bei Krebsbetroffenen im erwerbsfähigen Alter stellen sich von Diagnose und Behandlungsbeginn an zumeist auch arbeitsbezogene Fragestellungen. In der CARES-Studie (Cancer Rehabilitation … Support by Cancer Counseling Centers) wurden Berufslots\*innen in Krebsberatungsstellen (KBS) fortgebildet, die Ratsuchende rund um berufliche Themen unterstützen können. **Fragestellung** Wer nimmt das Berufslots\*innenangebot in Anspruch? Welche Vorteile und Optimierungsmöglichkeiten nehmen Ratsuchende, Berufslots\*innen und Zuweisende vom Berufslots\*innenprogramm wahr? **Methode** CARES ist eine quasiexperimentelle Machbarkeitsstudie. In 19 KBS wurden zunächst Ratsuchende vor Einführung des Berufslots\*innenprogramms (Vergleichsgruppe [VG]) und anschließend Ratsuchende nach Schulung der Berufslots\*innen (Interventionsgruppe [IG], vorläufige Ergebnisse) eingeschlossen. In diesem Beitrag werden Befragungsdaten zum ersten Befragungszeitpunkt zu Beginn der Beratung berichtet. Zudem wurden semistrukturierte Interviews geführt. Diese wurden inhaltsanalytisch ausgewertet. **Ergebnisse** Teilnehmende an CARES (VG: n = 293/IG: n = 326) waren mehrheitlich weiblich und hatten einen (Fach‑)Hochschulabschluss. An den Interviews nahmen 16 Ratsuchende, 11 Berufslots\*innen und 5 Zuweisende teil. Als Vorteile des Programms wurden u. a. die unmittelbare Unterstützung und Hilfe bei bürokratischen Prozessen, erhöhte zeitliche Kapazitäten sowie die Schließung einer Lücke in der Versorgungslandschaft genannt. Als Optimierungsmöglichkeiten wurden u. a. Beratungstermine in den Abendstunden bzw. im Onlineformat. **Schlussfolgerung** Ratsuchende, Berufslots\*innen wie auch Zuweisende nehmen das Berufslots\*innenprogramm als vorteilhaft wahr, z. B. als Möglichkeit, Patient\*innen mit Bedarf für Unterstützung bei beruflichen Themen zu verweisen und so eine Lücke in der Versorgung zu schließen.

Authors: Clara Breidenbach, Paula Heidkamp, Kati Hiltrop, Lina Heier, Johanna Weiß, Marie Rösler, Sabine Schneider, Sophie Schellack, Johannes Soff, Christoph Kowalski, Nicole Ernstmann

Date Published: 2nd Aug 2024

Publication Type: Journal

Cancer rehabilitation support by cancer counselling centres (CARES): study protocol of a quasi-experimental feasibility study.

Abstract (Expand)

INTRODUCTION: While maintaining or restoring work ability after a cancer diagnosis is an essential aim of the rehabilitation process for working-age patients, problems can arise during the return to … work (RTW) or when retaining work. Counselling could provide support for patients with or after cancer with employment-related questions (eg, questions related to RTW and work retention). Outpatient psychosocial cancer counselling centres in Germany offer counselling on work-related questions; however, resources for this are limited. This protocol presents a feasibility study of an intensified needs-based counselling intervention that supports those seeking employment-related advice. METHODS AND ANALYSIS: The CARES (cancer rehabilitation support by cancer counselling centres) project is a feasibility study for a newly developed counselling intervention. The intervention is being developed as part of the project and piloted in about 20 outpatient cancer counselling centres. The CARES study has a quasi-experimental pre-post design with a control cohort. First, patients who undergo regular counselling are recruited. Second, after the counsellors have been trained for the newly developed intervention, participants for the intervention group are recruited from the cancer counselling centres. Quantitative and formative evaluations will be performed in accordance with the existing guidelines. The quantitative evaluation comprises three patient surveys (at the beginning of the counselling process, 3 months into the counselling process and, for the intervention group, at the end of the counselling process) and routine data of the counselling process. The formative evaluation includes interviews with patients, counsellors and other stakeholders, as well as participatory observations of counselling sessions. ETHICS AND DISSEMINATION: Approval has been obtained from the ethics committee of the Medical Faculty of the University Bonn (061/22; 09.04.2022). A data protection concept ensures adherence to data protection regulations for the handled data. The dissemination strategies include discussing the results with the cancer counselling centres. TRIAL REGISTRATION NUMBER: German Clinical Trials Register (DRKS00028121); Pre-results.

Authors: K. Hiltrop, P. Heidkamp, C. Breidenbach, C. Kowalski, G. Bruns, N. Ernstmann

Date Published: 11th Aug 2023

Publication Type: Journal

Response-adapted lenalidomide maintenance in newly diagnosed myeloma: results from the phase III GMMG-MM5 trial.

Abstract (Expand)

The MM5 trial aimed at demonstrating a progression-free survival (PFS) difference in continued vs. response-adapted (in case of complete response, CR) lenalidomide (LEN) maintenance therapy (MT) in … newly diagnosed, transplant-eligible multiple myeloma (MM). Patients were equally randomized to receive induction therapy with PAd (bortezomib/doxorubicin/dexamethasone) or VCD (bortezomib/cyclophosphamide/dexamethasone), high-dose melphalan and autologous blood stem cell transplantation, and LEN consolidation, followed by either LEN MT for a fixed duration of 2 years (LEN-2Y) or until achievement of CR (LEN-CR, intention-to-treat population n = 502): arms A1:PAd + LEN-2Y (n = 125), B1:PAd + LEN-CR (n = 126), A2:VCD + LEN-2Y (n = 126), B2:VCD + LEN-CR (n = 125). In the LEN-CR group (B1 + B2), n = 88/17.5% patients did not start or discontinued LEN MT due to CR. There was no PFS (p = 0.60, primary endpoint) nor overall survival (OS) (p = 0.15) difference between the four study arms. On pooled LEN MT strategies, OS (hazard ratio, hazard ratio [HR] = 1.42, p = 0.03) but not PFS (HR = 1.15, p = 0.20) was shorter in LEN-CR (B1 + B2) vs. LEN-2Y (A1 + A2) groups. PFS was shortened on landmark analyses from the start of LEN MT in patients being in CR in the LEN-CR group (LEN-CR vs. LEN-2Y, HR = 1.84, p = 0.02). OS from first progression was shortened in the LEN-CR vs. LEN-2Y group (HR = 1.60, p = 0.01). LEN MT should be applied beyond CR for at least 2 years.

Authors: H. Goldschmidt, E. K. Mai, J. Durig, C. Scheid, K. C. Weisel, C. Kunz, U. Bertsch, T. Hielscher, M. Merz, M. Munder, H. W. Lindemann, B. Hugle-Dorr, D. Tichy, N. Giesen, D. Hose, A. Seckinger, S. Huhn, S. Luntz, A. Jauch, A. Elmaagacli, B. Rabold, S. Fuhrmann, P. Brossart, M. Goerner, H. Bernhard, M. Hoffmann, J. Hillengass, M. S. Raab, I. W. Blau, M. Hanel, H. J. Salwender

Date Published: 9th Feb 2020

Publication Type: Journal

Peripheral neuropathy associated with subcutaneous or intravenous bortezomib in patients with newly diagnosed myeloma treated within the GMMG MM5 phase III trial.

Abstract

Not specified

Authors: M. Merz, H. Salwender, M. Haenel, E. K. Mai, U. Bertsch, C. Kunz, T. Hielscher, I. W. Blau, C. Scheid, D. Hose, A. Seckinger, A. Jauch, J. Hillengass, M. S. Raab, B. Schurich, M. Munder, P. Brossart, C. Gerecke, H. W. Lindemann, M. Zeis, K. Weisel, J. Duerig, H. Goldschmidt

Date Published: 20th Aug 2016

Publication Type: Journal

Phase III trial of bortezomib, cyclophosphamide and dexamethasone (VCD) versus bortezomib, doxorubicin and dexamethasone (PAd) in newly diagnosed myeloma.

Abstract (Expand)

We aimed at demonstrating non-inferiority of bortezomib/cyclophosphamide/dexamethasone (VCD) compared to bortezomib/doxorubicin/dexamethasone (PAd) induction therapy with respect to very good partial … response rates or better (⩾VGPR) in 504 newly diagnosed, transplant-eligible multiple myeloma patients. VCD was found to be non-inferior to PAd with respect to ⩾VGPR rates (37.0 versus 34.3%, P=0.001). The rates of progressive disease (PD) were 0.4% (VCD) versus 4.8% (PAd; P=0.003). In the PAd arm, 11 of 12 patients with PD had either renal impairment (creatinine ⩾2 mg/dl) at diagnosis or the cytogenetic abnormality gain 1q21, whereas no PD was observed in these subgroups in the VCD arm. Leukocytopenia/neutropenia (⩾3 degrees ) occurred more frequently in the VCD arm (35.2% versus 11.3%, P<0.001). Neuropathy rates (⩾2 degrees ) were higher in the PAd group (14.9 versus 8.4%, P=0.03). Serious adverse events, both overall and those related to thromboembolic events, were higher in the PAd group (32.7 versus 24.0%, P=0.04 and 2.8 versus 0.4%, P=0.04). Stem cell collection was not impeded by VCD. VCD is as effective as PAd in terms of achieving ⩾VGPR rates with fewer PD and has a favorable toxicity profile. Therefore, VCD is preferable to PAd as induction therapy.

Authors: E. K. Mai, U. Bertsch, J. Durig, C. Kunz, M. Haenel, I. W. Blau, M. Munder, A. Jauch, B. Schurich, T. Hielscher, M. Merz, B. Huegle-Doerr, A. Seckinger, D. Hose, J. Hillengass, M. S. Raab, K. Neben, H. W. Lindemann, M. Zeis, C. Gerecke, I. G. Schmidt-Wolf, K. Weisel, C. Scheid, H. Salwender, H. Goldschmidt

Date Published: 20th Mar 2015

Publication Type: Journal

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