Immunotherapies and targeted therapies have revolutionised treatment of metastatic melanoma and improved survival rates. However, survivors treated with novel therapies are vulnerable to high levels of fear of cancer recurrence or progression (FCR). Existing FCR interventions have rarely been trialled in people with advanced cancer. The current study aimed to evaluate the acceptability and feasibility of Fear-Less: a stepped-care model to treat FCR in people with metastatic melanoma treated with immunotherapy or targeted therapy. Sixty-one outpatients with metastatic melanoma were screened using the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) and Fear of Progression Questionnaire Short Form (FoP-Q-SF). Survivors with subthreshold FCR were stratified to a self-management intervention while those with clinical levels of FCR were provided with an individual therapy, Conquer Fear. Survivor experience surveys and rescreening were administered post-intervention completion. Results indicated that Fear-Less was an acceptable and feasible FCR intervention. Results provided preliminary support for the potential impact of Fear-Less in reducing FCR. Fear-Less is a promising first step in providing an acceptable and feasible stepped-care model to treat FCR in survivors with metastatic disease.

Introduction People with advanced non-small cell lung cancer (NSCLC) treated with immunotherapies (IT) or targeted therapies (TT) may have improved outcomes in a subset of people who respond, raising unique psychological concerns requiring specific attention. These include the need for people with prolonged survival to reframe their life plans and tolerate uncertainty related to treatment duration and prognosis. A brief intervention for people with advanced cancer, Managing Cancer and Living Meaningfully (CALM), could help people treated with IT or TT address these concerns. However, CALM has not been specifically evaluated in this population. This study aims to evaluate the acceptability and feasibility of CALM in people with advanced NSCLC treated with IT or TT and obtain preliminary evidence regarding its effectiveness in this population. Methods and analysis Twenty people with advanced NSCLC treated with IT or TT will be recruited from Peter MacCallum Cancer Centre, Melbourne, Australia. Participants will complete three to six sessions of CALM delivered over 3–6 months. A prospective, single-arm, mixed-methods pilot study will be conducted. Participants will complete outcome measures at baseline, post-intervention, 3 months and 6 months, including Patient Health Questionnaire, Death and Dying Distress Scale, Functional Assessment of Cancer Therapy General and Clinician Evaluation Questionnaire. The acceptability of CALM will be assessed using patient experiences surveys and qualitative interviews. Feasibility will be assessed by analysis of recruitment rates, treatment adherence and intervention delivery time. Ethics and dissemination Ethics approval has been granted by the Peter MacCallum Cancer Centre Human Research Ethics Committee (HREC/82047/PMCC). Participants with cancer will complete a signed consent form prior to participation, and carers and therapists will complete verbal consent. Results will be made available to funders, broader clinicians and researchers through conference presentations and publications. If CALM is found to be acceptable in this cohort, this will inform a potential phase 3 trial.

Background: Autologous stem cell transplant (AuSCT) improves survival in haematological cancers, yet often involves a lengthy recovery associated with a myriad of psychological and physical challenges. Psychological prehabilitation is recommended to improve functional outcomes by addressing psychological concerns and promoting optimal mental and physical health prior to AuSCT. Despite this, little is known about the implementation and experiences of psychology‐specific prehabilitation for AuSCT. Aims: The current study explores the perspectives and experiences of AuSCT recipients and healthcare professionals (HCPs), regarding optimal psychological prehabilitation. Methods: Qualitative interviews were conducted with AuSCT recipients and HCPs experienced in working with AuSCT recipients. AuSCT recipients were recruited at a regional Victorian public health service offering psychological prehabilitation. Purposive sampling was used for HCPs, ensuring a range of professions participated. Reflexive thematic analysis was conducted on interview data, with triangulation utilised to identify themes. Results: Nine AuSCT recipients and 12 HCPs participated. All themes were shared across AuSCT recipients and HCPs. Four themes (each with subthemes) were identified: Fostering Psychological Preparedness for Transplant (Exploring Expectations, Addressing Psychological Concerns), Getting Through the Long Haul (Prioritising Social Support, Planning Emotional and Practical Care), Strengthening Engagement with Psychology (Destigmatising Psychology, Psychology Enhances Overall Prehabilitation) and Looking Toward Sustainability (Individualised Stepped‐Care, Screening and Risks) . Conclusions: Psychological prehabilitation is considered crucial for optimal preparation and recovery from AuSCT, however stigma and limited psychology resources can impact access. Future research should investigate sustainable models of psychological prehabilitation, such as stepped care, to adequately meet the needs of this growing population.