Understanding Quality of Life Priorities in Later-Line Colon Cancer

Dr. Thejus Jayakrishnan sat down with CURE at the 2026 ASCO Gastrointestinal Cancers Symposium to discuss research he presented evaluating how patients and physicians weigh treatment options in later-line metastatic colorectal cancer.

Jayakrishnan, who is a gastrointestinal medical oncologist at Dana-Farber Cancer Institute and Brigham and Women's Hospital, was well as an instructor in medicine at Harvard Medical School, in Boston, explored differences in priorities between patients and clinicians, including survival expectations and quality-of-life considerations

Transcript

What were you trying to better understand in the research you presented at the ASCO Gastrointestinal Cancers Symposium, particularly regarding how patients and physicians make treatment decisions in later-line metastatic colorectal cancer?

I presented a poster... that assessed patient and physician choices when making decisions regarding treatments for metastatic colorectal cancer, especially in the later-line setting. Later-line means people who have had their cancer progress through earlier treatment strategies and are now requiring a third-line or fourth-line treatment. We looked at how they weigh the choices that are available.

I will tell you briefly about the study itself. In the study, we sent out surveys to patients and also to treating providers—people who take care of individuals with metastatic colorectal cancer and administer treatments. We tried to gauge the considerations that are important for them, … but also what trade-offs they are willing to make. For example, how much survival are you willing to compromise on if your quality of life can be preserved? Because these are the kind of trade-offs and choices that physicians and patients have to make, it was a survey exercise to gauge priorities and figure out what trade-offs people are willing to make.

What we found was that, obviously, the most important attribute for any treatment is survival, or the ability to live longer, for both patients and physicians. However, we found that while more than 50% of the physicians ranked survival as the number one priority, less than half of the patients actually noted that as the number one thing. This indicates that quality of life and adverse event considerations are very important for patients.

We have treatment options that include oral-only treatments and treatments that include pills plus intravenous infusions. Patients and physicians both considered oral-only pills as a preferable treatment option. Then, looking at adverse events, it was very interesting because for physicians, the most important adverse event we were worried about was neutropenia, which is basically a drop in blood counts that help fight infection. Those are markers that we see on routine blood work that may prompt changes in treatments. But for patients, the number one consideration was fatigue. That was the main adverse event that patients were worried about and that they thought would impact their quality of life when making these choices.

Transcript has been edited for clarity and conciseness.

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