Evidence map›Paper›PMID 40011242›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

Double burden: financial toxicity in patients with advanced soft tissue sarcoma at the start of first-line palliative chemotherapy: baseline data from the HOLISTIC study.

E Roets, E Younger, R L Jones, D den Hollander, I M E Desar, R J Young, A W Oosten, J J de Haan, H Gelderblom, N Steeghs and 2 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

E RoetsDepartment of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
E YoungerSarcoma Unit, Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK.
R L JonesSarcoma Unit, Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK.
D den HollanderDepartment of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands.
I M E DesarDepartment of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands.
R J YoungAcademic Unit of Clinical Oncology, The University of Sheffield, Sheffield, UK.
A W OostenDepartment of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
J J de HaanDepartment of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
H GelderblomDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
N SteeghsDepartment of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
W T A van der Graaf *Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
O Husson *Department of Medical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. o.husson@erasmusmc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe HOLISTIC study assessed health-related quality of life (HRQoL) in advanced soft tissue sarcoma (STS) patients receiving first-line palliative chemotherapy. The secondary objective discussed here is to evaluate baseline self-reported financial difficulties and associated sociodemographic factors and global health status (GHS), compare financial toxicity between patients in the United Kingdom (UK) and the Netherlands (NL), and evaluate the consequences of financial toxicity.

methodsThis prospective study included 72 UK and 65 NL patients. Financial toxicity was evaluated by the financial difficulties scale of the EORTC QLQ-C30. Associated factors (i.e., country, gender, educational level, relationship status, employment changes, income, age, time since diagnosis, and GHS) were analyzed using descriptive analysis, Chi-square tests, and univariate and multivariate logistic regression.

resultsMedian participant age was 62 (range: 27-79) years, and gender distribution was equal. 58% of UK and 48% of NL patients had no income or a monthly income ≤ £/€ 2000 (p = 0.417). Self-reported additional costs for medication (31% vs. 9%, p < 0.001) and parking (75% vs. 41%, p < 0.001) were more prevalent among Dutch than UK patients. Travel expenses were similar: 68% in NL and 66% in UK. Univariate analysis showed an increased risk of financial toxicity in UK patients (40% vs. 22% [NL], p = 0.023), single patients (52% vs. 27% [with partner], p = 0.014), and those with a change in employment status (46% vs. 24% [no change], p = 0.019). In UK patients, multivariate analysis indicated lower odds for financial toxicity for patients with a high income (OR 0.207, p = 0.031) and higher odds for patients with a worse GHS (OR 5.171, p = 0.012), whereas in NL, higher odds were seen for male (OR 13.286, p = 0.027) and single (OR 41.735, p = 0.007) patients.

conclusionFinancial toxicity was common among advanced STS already at the start of palliative chemotherapy, influenced by factors such as residence country, income, relationship status, gender, and GHS. Timely interventions are needed to address financial challenges in this population.

Indexed as

Antineoplastic AgentsCost of IllnessPalliative CareQuality of LifeSarcomaAdultAgedFemaleHealth StatusHumansLogistic ModelsMaleMiddle AgedNetherlandsProspective StudiesUnited KingdomAntineoplastic AgentsCostEmploymentFinancial toxicityQuality of lifeSarcoma

Identifiers

PMID40011242
PMCPMC11865148

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.