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Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

1. Participants will identify knowledge about immunotherapy as an important educational target for adults with advanced cancer that may be addressed through a video and question prompt list intervention. 2. Participants will be able to appraise the feasibility of one approach to improving patient and caregiver knowledge about immunotherapy for advanced cancer. Immunotherapy has revolutionized cancer treatment and causes novel toxicities that are important for patients to understand. We developed a video and question prompt list intervention to educate patients about immunotherapy. In a randomized controlled trial, we found that the intervention was feasible to deliver, acceptable, and improved immunotherapy knowledge versus usual care among adults with advanced cancer, without increasing anxiety. Immune checkpoint inhibitors (ICIs) improve cancer survival and cause novel toxicities. We developed UPLIFT (Understanding and Preparing for Life on Immunotherapy), an educational video and question prompt list (QPL) intervention for adults initiating ICIs. To test the feasibility and acceptability of UPLIFT and its effects on immunotherapy knowledge and anxiety. We conducted a pilot randomized controlled trial (NCT04670445) of UPLIFT among adults initiating an ICI for advanced cancer. Participants were randomized 1:1 to receive UPLIFT prior to ICI initiation or usual care. Participants completed surveys at enrollment (baseline), within 72 hours after ICI initiation (72h), and at 6 weeks. The primary outcome was feasibility (70% enrollment among approached patients and 80% video completion and QPL review). We also assessed acceptability, immunotherapy knowledge (8-item survey, scored as % correct), and anxiety (State and Trait Anxiety Index-Short Form). We used ANCOVA models to analyze knowledge and anxiety outcomes. We enrolled 130 of 178 approached, eligible patients (73%). 66 patients were randomized to receive UPLIFT and 65 to control. Patients (38% female, mean age=67y) had diagnoses of melanoma (40%), lung cancer (26%), or other cancers (34%). All 66 (100%) patients assigned to UPLIFT watched the video and received the QPL. 94% of patients were "somewhat" or "very comfortable" with UPLIFT. Immunotherapy knowledge improved from baseline to 72h among patients assigned to UPLIFT relative to control (difference in adjusted mean % correct: 9% [95% CI: 3% - 16%]). The change in anxiety from baseline to 72h did not significantly differ between groups (0.6, 95% CI: -2.6 - 3.8). There were no between-group differences in knowledge or anxiety score change from baseline to 6 weeks. A novel educational intervention was feasible to deliver, acceptable, and improved immunotherapy knowledge relative to usual care among adults with advanced cancer, without increasing anxiety. Communication / Disease specific management [ABSTRACT FROM AUTHOR]

1. Recognize the challenges of communicating prognosis in the setting of prognostic uncertainty and identify opportunities to explore and respond to patients' and caregivers' interest in prognostic information 2. Apply lessons from the experiences of patients, caregivers, and clinicians from prognostic discussions in order to engage in patient-centered communication with patients who receive targeted therapy for cancer or patients in other clinical settings where prognostic uncertainty prevails Targeted therapy extends survival for lung cancer, but wide variability in patient outcomes makes prognostication for individual patients difficult. This study aims to describe prognostic communication among patients receiving targeted therapy for lung cancer, their caregivers, and clinicians, and identify facilitators and barriers of these discussions. In this qualitative study, we included patients with advanced lung cancer receiving targeted therapy and their caregivers, as well as thoracic oncologists and nurse practitioners. We audio-recorded patients' appointments (1 per patient), conducted semistructured interviews with patients and caregivers, and held focus groups with clinicians. We coded and analyzed the data via a framework approach and compared themes regarding prognostic communication preferences and behaviors across data sources. We enrolled 39 patients (median age = 59 years; 59% female; 77% White and 10% Asian), 14 caregivers, and 10 clinicians. In audio-recorded visits, patients' and caregivers' curiosity about prognosis arose in the context of indirect questions about symptoms and scan results and occasional direct questions about timeframe or expected functional changes. Interview data indicated that most patients and caregivers wanted more information about what to expect, but many surmised that uncertainty made it impossible for their clinicians to provide that information. Clinicians emphasized in focus groups that the shifting landscape of treatment options limited their ability to prognosticate and that patients' high expectations of therapy influenced their discussions. They reported that they introduce targeted therapy very optimistically to patients because of its advantages over chemotherapy, but some felt that their enthusiasm overshadowed the gravity of a metastatic cancer diagnosis. Although uncertainty complicates the ability to provide prognostic estimates, patients with lung cancer and caregivers desire more information and often ask their clinicians indirect questions, providing opportunities for discussion. Precision oncology advances necessitate guidance for prognostic communication in the setting of uncertainty. [ABSTRACT FROM AUTHOR]