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Abstract

This study addresses the imperative for enhanced measurement of clinically significant symptoms in advanced cancer, focusing on Health-Related Quality of Life (HRQOL) as a pivotal endpoint in assessing treatment outcomes. The National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy (NCCN-FACT) advanced cancer symptom indexes were developed through a meticulous, multi-step methodology adhering to regulatory guidelines for patient-reported outcome measures. Eleven NCCN-FACT advanced cancer-specific symptom indices were designed to capture the most relevant symptoms identified by oncology clinicians and individuals with advanced cancer. This paper provides a succinct overview of the development of NCCN-FACT scales, highlighting their advantages over previous measures, including brevity, clinical relevance, and enhanced regulatory acceptance. We explore potential applications of these measures in palliative care, addressing interpretability-related concerns. Additionally, we present the NCCN-FACT-Ovarian Symptom Index-18 (NFOSI-18) and its precursor, the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) Treatment Outcome Index (TOI), to illustrate how results from NCCN-FACT symptom indexes can be employed and interpreted in clinical practice. Given the preliminary nature of research reporting the use of NCCN-FACT symptom indexes and their content overlap with precursor measures, we suggest that published clinical trial data using cancer-specific FACT measures can guide future utilization of NCCNFACT symptom indexes in both research and clinical practice.