Patient-centered and Efficacious Advance Care Planning in Cancer: the PEACe Comparative Effectiveness Trial

The overall goal of this study is to identify the most effective and efficient advance care planning (ACP) strategy for patients with advanced cancer. The specific aims are to: Aim 1. Compare the effectiveness of in-person, facilitated ACP versus web-based ACP on patient and family caregiver outcomes. Aim 2. Assess implementation costs and the effects of in-person, facilitated ACP and web-based ACP on healthcare utilization at end of life. Aim 3. Identify contexts and mechanisms that influence the effectiveness of in-person, facilitated ACP versus web-based ACP.

Sex

All

Minimum age

18 Years

Patient Inclusion Criteria:

1. 18 years of age or older
2. Solid tumor
3. The oncologist "would not be surprised" if the patient died within the next year
4. Eastern Cooperative Oncology Group performance status (ECOG PS) of 0, 1, or 2
5. Planning to receive ongoing care at a participating oncology clinic
6. Willing to participate in either a web-based or facilitated program

Patient Exclusion Criteria:

1. Does not speak English
2. Inability to consent, using a validated teach-back method
3. Hematologic malignancy
4. No phone for additional study contacts and follow-up interviews
5. Unable to participate in advance care planning, as assessed by clinician
6. Unable to complete the baseline interview

Patients will be able to identify and enroll a caregiver, designated by the patient as the primary family member or friend involved in their care and best able to participate in the study.

Caregiver Inclusion criteria:

1. 18 years of age or older
2. Family member or friend of an eligible patient
3. Primary person involved in patient's care and best able to participate in the study, as assessed by patient

Caregiver Exclusion criteria:

1. Does not speak English
2. No phone for additional study contacts and follow-up interviews
3. Unable to complete the baseline interview

• DERIVEDCrowley F, Belin S, Wang T, Applebaum A, Ferrell B, Flowers R, Sudore R, White D, Crowley-Makota M, Hammes B, Arnold R, Schenker Y. Advance care planning impact on caregivers and end-of-life care in advanced cancer. J Natl Cancer Inst. 2026 Apr 1;118(4):626-635. doi: 10.1093/jnci/djaf331. PMID 41233979
• DERIVEDSchenker Y, Belin SC, Wang T, Sudore RL, Hammes B, Arnold RM, Flowers R, Chiu E, Hall J, Dudley-Morrissey Y, Ferrell B, Crowley-Matoka M, Brufsky A, Chu E, Gorantla V, Mehta D, Thomas R, Yee M, White D. Facilitated Versus Patient-Directed Advance Care Planning Among Patients With Advanced Cancer: A Randomized Clinical Trial. JCO Oncol Pract. 2025 Oct;21(10):1447-1457. doi: 10.1200/OP-25-00046. Epub 2025 Mar 19. PMID 40106743