Background Biological and precision therapies (known as targeted therapies) have been a significant success in the treatment of metastatic cancer. The number licenced is continually increasing. However, in contrast to what was originally anticipated, these therapies are associated with a wide range of side-effects. Since these therapies may be given for prolonged periods of time, even relatively ‘minor’ side-effects could have a major impact on patient function and quality of life. In addition, there is no standard treatment duration; instead patients continue on a drug until either the cancer progresses or, occasionally, disappears. The rapid evolution of drugs means patients, and their doctors, are often uncertain if another suitable drug will be available when/if the current one stops working. This means there is considerable potential for people using these therapies to experience their treatment differently, and to have different needs for support and care, than those receiving traditional chemotherapy. The TARGET study aimed to explore experiences and needs of people treated with targeted therapies to develop a unmet supportive care needs assessment instrument for this group.

Methods TARGET used a mixed methods sequential design across four phases. Phase 1 involved a systematic review of existing care needs assessment tools for metastatic cancer; Phase 2 included semi-structured interviews with patients and professionals; Phase 3 involved development of a new care needs assessment questionnaire; and Phase 4 involved a survey testing new care needs assessment. Patients with the following tumours were included: lung, breast (female), malignant melanoma, colorectal, renal and ovarian.Eligibility included aged ≥18 years, metastatic disease, currently receiving targeted therapy (including immunotherapy), and concluded other anti-cancer treatment at least 3 months prior to recruitment.

Results The systematic review identified 24 existing instruments to assess unmet needs in patients with metastatic cancer. Several had potential to be adapted for this patient group. The interviews (n=31 patients; n=22 healthcare professionals) revealed this patient group had unmet needs unique to their treatment experience. The findings from Phase 1 and 2 were consolidated to develop a new module to add on to an existing questionnaire. This was piloted following COSMIN guidelines. The survey of the new care needs assessment is currently ongoing.

Conclusion TARGET has revealed unique unmet needs in cancer patients receiving targeted therapy and developed a new instrument to assess these. The findings could inform development of services to better meet the needs of this new and rapidly expanding patient group.