{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:57:03Z","timestamp":1791896223530,"version":"4.3.4"},"reference-count":39,"publisher":"Harborside Press, LLC","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Individuals with cancer often use numerous coping strategies. However, little is known about coping behavior among patients enrolled on early-phase cancer clinical trials (EPCTs).\n                    <jats:bold>Methods:<\/jats:bold>\n                    We prospectively enrolled adults with cancer initiating EPCTs at Massachusetts General Hospital from April 2021 to March 2025. Participants completed surveys at the time of EPCT enrollment assessing coping (Brief COPE [Coping Orientation to Problems Experienced]; scores range 0\u20136), quality of life (QoL; Functional Assessment of Cancer Therapy\u2013General [FACT-G]), depression and anxiety symptoms (Patient Health Questionnaire-4 [PHQ-4]), symptom burden (Edmonton Symptom Assessment Scale [ESAS]), and financial well-being (Comprehensive Score for Financial Toxicity [COST]). We used regression models to explore associations of coping strategies with patient-reported and clinical outcomes.\n                    <jats:bold>Results:<\/jats:bold>\n                    Among 195 participants enrolled, 188 completed the survey assessments (96.4% response rate). Among these participants (median age, 63.5 [range, 31.8\u201388.6]; 56.4% female), the most common cancer types were gastrointestinal (34.0%) and breast (20.7%). At the time of EPCT enrollment, patients\u2019 coping strategies included acceptance (mean Brief COPE score, 4.77), emotional support (mean score, 4.60), active coping (mean score, 4.25), positive reframing (mean score, 3.11), religion (mean score, 2.85), self-blame (mean score, 0.88), denial (mean score, 0.62), and behavioral disengagement (mean score, 0.35). Greater use of approach-oriented strategies (acceptance, emotional support, and positive reframing) and lower use of avoidant strategies (denial, self-blame, and behavioral disengagement) were associated with better QoL, fewer symptoms of depression and anxiety, lower symptom burden, and greater financial well-being (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.05). Greater use of denial coping was associated with a lower risk of hospitalizations (hazard ratio [HR], 0.76;\n                    <jats:italic>P<\/jats:italic>\n                    =.007). Use of acceptance coping was associated with lower odds of completing the dose-limiting toxicity (DLT) period (odds ratio, 0.57;\n                    <jats:italic>P<\/jats:italic>\n                    =.023) and with a shorter time on trial (HR, 1.16;\n                    <jats:italic>P<\/jats:italic>\n                    =.011). Use of emotional support coping was associated with a shorter time on trial (HR, 1.13;\n                    <jats:italic>P<\/jats:italic>\n                    =.016) and worse survival (HR, 1.17;\n                    <jats:italic>P<\/jats:italic>\n                    =.005). Use of religion (HR, 1.09;\n                    <jats:italic>P<\/jats:italic>\n                    =.035) and positive reframing (HR, 1.11;\n                    <jats:italic>P<\/jats:italic>\n                    =.039) coping strategies was associated with worse survival.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    In this cohort of EPCT participants, we found associations of coping behaviors with patient outcomes. Specifically, approach-oriented coping strategies correlated with higher QoL and lower distress. Interventions seeking to enhance outcomes in this population should target the diverse coping strategies used by EPCT participants.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2026.7037","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:54:32Z","timestamp":1790168072000},"source":"Crossref","is-referenced-by-count":0,"title":["Coping Strategies Among Early-Phase Cancer Clinical Trial Participants"],"prefix":"10.6004","volume":"24","author":[{"given":"Anh B.","family":"Lam","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Brigham & Women\u2019s Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sienna","family":"Durbin","sequence":"additional","affiliation":[{"name":"Division of Hematology & Oncology, Dana-Farber Cancer Institute, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Lynch","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Petrillo","sequence":"additional","affiliation":[{"name":"Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Boulanger","sequence":"additional","affiliation":[{"name":"Division of Hematology & Oncology, Dana-Farber Cancer Institute, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Bame","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishnavi","family":"Yalala","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Ollila","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Malowitz","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casandra","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejan","family":"Juric","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan David","family":"Nipp","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, University of Oklahoma Health Stephenson Cancer Center, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Lundquist","sequence":"additional","affiliation":[{"name":"Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"J Psychosoc Oncol","first-page":"55","article-title":"Coping with cancer: what do patients do","volume":"23","author":"Zaza C","year":"2005","unstructured":"Zaza C, Sellick SM, Hillier LM. Coping with cancer: what do patients do. J Psychosoc Oncol 2005;23:55\u201373."},{"key":"B2","series-title":"Cancer","first-page":"2110","article-title":"The relationship between coping strategies, quality of life, and mood in patients with incurable cancer","volume":"122","author":"Nipp RD","year":"2016","unstructured":"Nipp RD, El-Jawahri A, Fishbein JN,  The relationship between coping strategies, quality of life, and mood in patients with incurable cancer. Cancer 2016;122:2110\u20132116."},{"key":"B3","series-title":"Support Care Cancer","first-page":"4133","article-title":"Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer","volume":"26","author":"Beesley VL","year":"2018","unstructured":"Beesley VL, Smith DD, Nagle CM,  Coping strategies, trajectories, and their associations with patient-reported outcomes among women with ovarian cancer. Support Care Cancer 2018;26:4133\u20134142."},{"key":"B4","series-title":"Oncologist","first-page":"166","article-title":"Coping strategies and associated symptom burden among patients with advanced cancer","volume":"29","author":"Dev R","year":"2024","unstructured":"Dev R, Agosta M, Fellman B,  Coping strategies and associated symptom burden among patients with advanced cancer. Oncologist 2024;29:166\u2013175."},{"key":"B5","series-title":"Clin Psychol Rev","first-page":"101882","article-title":"Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: aggregate data and individual patient data meta-analyses","volume":"80","author":"Buffart LM","year":"2020","unstructured":"Buffart LM, Schreurs MAC, Abrahams HJG,  Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: aggregate data and individual patient data meta-analyses. Clin Psychol Rev 2020;80:101882."},{"key":"B6","series-title":"Int J Soc Psychiatry","first-page":"888","article-title":"Effects of online coping skills training on stress, anxiety and social problem solving in young people: a randomised controlled study","volume":"70","author":"\u00d6zkan E","year":"2024","unstructured":"\u00d6zkan E, Altunta\u015f O. Effects of online coping skills training on stress, anxiety and social problem solving in young people: a randomised controlled study. Int J Soc Psychiatry 2024;70:888\u2013898."},{"key":"B7","series-title":"J Clin Oncol","first-page":"53","article-title":"Role of patient coping strategies in understanding the effects of early palliative care on quality of life and mood","volume":"36","author":"Greer JA","year":"2018","unstructured":"Greer JA, Jacobs JM, El-Jawahri A,  Role of patient coping strategies in understanding the effects of early palliative care on quality of life and mood. J Clin Oncol 2018;36:53\u201360."},{"key":"B8","series-title":"Eur J Oncol Nurs","first-page":"10","article-title":"The coping process of patients with cancer","volume":"16","author":"Chen PY","year":"2012","unstructured":"Chen PY, Chang HC. The coping process of patients with cancer. Eur J Oncol Nurs 2012;16:10\u201316."},{"key":"B9","series-title":"Perspect Psychol Sci","first-page":"591","article-title":"Regulatory flexibility: an individual differences perspective on coping and emotion regulation","volume":"8","author":"Bonanno GA","year":"2013","unstructured":"Bonanno GA, Burton CL. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspect Psychol Sci 2013;8:591\u2013612."},{"key":"B10","series-title":"J Clin Med","first-page":"4469","article-title":"Coping strategies, pain, and quality of life in patients with breast cancer","volume":"10","author":"O\u015bmia\u0142owska E","year":"2021","unstructured":"O\u015bmia\u0142owska E, Misi\u0105g W, Chabowski M, Jankowska-Pola\u0144ska B. Coping strategies, pain, and quality of life in patients with breast cancer. J Clin Med 2021;10:4469."},{"key":"B11","article-title":"What are clinical trials?","unstructured":"National Cancer Institute. What are clinical trials? Accessed May 3, 2024. Available at: https:\/\/www.cancer.gov\/research\/participate\/clinical-trials\/what-are-clinical-trials"},{"key":"B12","article-title":"Types and phases of clinical trials","unstructured":"American Cancer Society. Types and phases of clinical trials. Accessed May 3, 2024. Available at: https:\/\/www.cancer.org\/cancer\/managing-cancer\/making-treatment-decisions\/clinical-trials\/what-you-need-to-know\/phases-of-clinical-trials.html"},{"key":"B13","series-title":"JAMA","first-page":"2130","article-title":"Trends in the risks and benefits to patients with cancer participating in phase 1 clinical trials","volume":"292","author":"Roberts TG","year":"2004","unstructured":"Roberts TG, Goulart BH, Squitieri L,  Trends in the risks and benefits to patients with cancer participating in phase 1 clinical trials. JAMA 2004;292:2130\u20132140."},{"key":"B14","series-title":"Clin Cancer Res","first-page":"1726","article-title":"Approaches to phase 1 clinical trial design focused on safety, efficiency, and selected patient populations: a report from the clinical trial design task force of the national cancer institute investigational drug steering committee","volume":"16","author":"Ivy SP","year":"2010","unstructured":"Ivy SP, Siu LL, Garrett-Mayer E, Rubinstein L. Approaches to phase 1 clinical trial design focused on safety, efficiency, and selected patient populations: a report from the clinical trial design task force of the national cancer institute investigational drug steering committee. Clin Cancer Res 2010;16:1726\u20131736."},{"key":"B15","series-title":"Cancer","first-page":"e35586","article-title":"Financial toxicity in early-phase cancer clinical trial participants","volume":"131","author":"Durbin SM","year":"2025","unstructured":"Durbin SM, Lundquist D, Pelletier A,  Financial toxicity in early-phase cancer clinical trial participants. Cancer 2025;131:e35586."},{"key":"B16","series-title":"JCO Oncol Pract","first-page":"1252","article-title":"Time toxicity experienced by early-phase cancer clinical trial participants","volume":"20","author":"Durbin SM","year":"2024","unstructured":"Durbin SM, Lundquist DM, Pelletier A,  Time toxicity experienced by early-phase cancer clinical trial participants. JCO Oncol Pract 2024;20:1252\u20131262."},{"key":"B17","series-title":"J Pain Symptom Manage","first-page":"131","article-title":"Coping in patients with incurable lung and gastrointestinal cancers: a validation study of the Brief COPE","volume":"53","author":"Hagan TL","year":"2017","unstructured":"Hagan TL, Fishbein JN, Nipp RD,  Coping in patients with incurable lung and gastrointestinal cancers: a validation study of the Brief COPE. J Pain Symptom Manage 2017;53:131\u2013138."},{"key":"B18","series-title":"Int J Behav Med","first-page":"92","article-title":"You want to measure coping but your protocol\u2019s too long: consider the Brief COPE","volume":"4","author":"Carver CS","year":"1997","unstructured":"Carver CS. You want to measure coping but your protocol\u2019s too long: consider the Brief COPE. Int J Behav Med 1997;4:92\u2013100."},{"key":"B19","series-title":"J Clin Oncol","first-page":"5335","article-title":"The functional assessment of cancer therapy scale: development and validation of the general measure","volume":"41","author":"Cella DF","year":"2023","unstructured":"Cella DF, Tulsky DS, Gray G,  The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 2023;41:5335\u20135344."},{"key":"B20","series-title":"J Affect Disord","first-page":"86","article-title":"A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population","volume":"122","author":"L\u00f6we B","year":"2010","unstructured":"L\u00f6we B, Wahl I, Rose M,  A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord 2010;122:86\u201395."},{"key":"B21","series-title":"J Palliat Care","first-page":"6","article-title":"The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients","volume":"7","author":"Bruera E","year":"1991","unstructured":"Bruera E, Kuehn N, Miller MJ,  The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 1991;7:6\u20139."},{"key":"B22","series-title":"Cancer","first-page":"476","article-title":"Measuring financial toxicity as a clinically relevant patient-reported outcome: the validation of the COmprehensive Score for financial Toxicity (COST)","volume":"123","author":"de Souza JA","year":"2017","unstructured":"de Souza JA, Yap BJ, Wroblewski K,  Measuring financial toxicity as a clinically relevant patient-reported outcome: the validation of the COmprehensive Score for financial Toxicity (COST). Cancer 2017;123:476\u2013484."},{"key":"B23","series-title":"Am J Cancer Res","first-page":"1121","article-title":"Clinical endpoints in oncology \u2013 a primer","volume":"11","author":"Delgado A","year":"2021","unstructured":"Delgado A, Guddati AK. Clinical endpoints in oncology \u2013 a primer. Am J Cancer Res 2021;11:1121\u20131131."},{"key":"B24","series-title":"Cancer J","first-page":"386","article-title":"Progression-free survival: gaining on overall survival as a gold standard and accelerating drug development","volume":"15","author":"Lebwohl D","year":"2009","unstructured":"Lebwohl D, Kay A, Berg W,  Progression-free survival: gaining on overall survival as a gold standard and accelerating drug development. Cancer J 2009;15:386\u2013394."},{"key":"B25","series-title":"Psychol Aging","first-page":"127","article-title":"Age and sex differences in strategies of coping and defense across the life span","volume":"11","author":"Diehl M","year":"1996","unstructured":"Diehl M, Coyle N, Labouvie-Vief G. Age and sex differences in strategies of coping and defense across the life span. Psychol Aging 1996;11:127\u2013139."},{"key":"B26","series-title":"Eur J Cancer","first-page":"1135","article-title":"Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution","volume":"32A","author":"Buccheri G","year":"1996","unstructured":"Buccheri G, Ferrigno D, Tamburini M. Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer 1996;32A:1135\u20131141."},{"key":"B27","series-title":"Cancer Med","first-page":"e70162","article-title":"Role of emotional control on anxiety and stress among cancer patients","volume":"13","author":"\u0141uczyk RJ","year":"2024","unstructured":"\u0141uczyk RJ, Sikora K, Bodio A,  Role of emotional control on anxiety and stress among cancer patients. Cancer Med 2024;13:e70162."},{"key":"B28","series-title":"Psychooncology","first-page":"163","article-title":"Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation","volume":"27","author":"van der Biessen DA","year":"2018","unstructured":"van der Biessen DA, van der Helm PG, Klein D,  Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation. Psychooncology 2018;27:163\u2013170."},{"key":"B29","series-title":"Annu Rev Psychol","first-page":"745","article-title":"Coping: pitfalls and promise","volume":"55","author":"Folkman S","year":"2004","unstructured":"Folkman S, Moskowitz JT. Coping: pitfalls and promise. Annu Rev Psychol 2004;55:745\u2013774."},{"key":"B30","series-title":"Can Psychol","first-page":"149","article-title":"Coping and emotion regulation: a conceptual and measurement scoping review","volume":"65","author":"Trudel-Fitzgerald C","year":"2024","unstructured":"Trudel-Fitzgerald C, Boucher G, Morin C,  Coping and emotion regulation: a conceptual and measurement scoping review. Can Psychol 2024;65:149\u2013162."},{"key":"B31","series-title":"Int J Psychiatry Med","first-page":"383","article-title":"Which cancer patients benefit most from a brief, group, coping skills program?","volume":"23","author":"Cunningham AJ","year":"1993","unstructured":"Cunningham AJ, Lockwood GA, Edmonds CV. Which cancer patients benefit most from a brief, group, coping skills program? Int J Psychiatry Med 1993;23:383\u2013398."},{"key":"B32","series-title":"Health Qual Life Outcomes","first-page":"121","article-title":"The benefits of psychosocial interventions for cancer patients undergoing radiotherapy","volume":"11","author":"Guo Z","year":"2013","unstructured":"Guo Z, Tang HY, Li H,  The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. Health Qual Life Outcomes 2013;11:121."},{"key":"B33","series-title":"Psychooncology","first-page":"1150","article-title":"Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: an individual patient data meta-analysis of 22 RCTs","volume":"27","author":"Kalter J","year":"2018","unstructured":"Kalter J, Verdonck-de Leeuw IM, Sweegers MG,  Effects and moderators of psychosocial interventions on quality of life, and emotional and social function in patients with cancer: an individual patient data meta-analysis of 22 RCTs. Psychooncology 2018;27:1150\u20131161."},{"key":"B34","series-title":"Psychooncology","first-page":"12","article-title":"Denial in cancer patients, an explorative review","volume":"16","author":"Vos MS","year":"2007","unstructured":"Vos MS, de Haes JC. Denial in cancer patients, an explorative review. Psychooncology 2007;16:12\u201325."},{"key":"B35","series-title":"Support Care Cancer","first-page":"443","article-title":"In their own words: a qualitative study of coping mechanisms employed by patients with acute myeloid leukemia","volume":"31","author":"Daniels NC","year":"2023","unstructured":"Daniels NC, Bodd MH, Locke SC, LeBlanc TW. In their own words: a qualitative study of coping mechanisms employed by patients with acute myeloid leukemia. Support Care Cancer 2023;31:443."},{"key":"B36","series-title":"Cancer Nurs","first-page":"101","article-title":"Stressors and coping strategies among female cancer survivors after treatments","volume":"30","author":"Lauver DR","year":"2007","unstructured":"Lauver DR, Connolly-Nelson K, Vang P. Stressors and coping strategies among female cancer survivors after treatments. Cancer Nurs 2007;30:101\u2013111."},{"key":"B37","series-title":"Asian Pac J Cancer Prev","first-page":"215","article-title":"Coping strategies and experiences in women with a primary breast cancer diagnosis","volume":"18","author":"Hajian S","year":"2017","unstructured":"Hajian S, Mehrabi E, Simbar M, Houshyari M. Coping strategies and experiences in women with a primary breast cancer diagnosis. Asian Pac J Cancer Prev 2017;18:215\u2013224."},{"key":"B38","series-title":"Br J Clin Psychol","first-page":"42","article-title":"Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking","volume":"57","author":"Liddon L","year":"2018","unstructured":"Liddon L, Kingerlee R, Barry JA. Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking. 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