IntroductionCommunication is an essential aspect of care for patients with progressive serious illnesses. This study aims to evaluate the efficacy of a new, integrated communication support program for oncologists, patients with rapidly progressing advanced cancer and their caregivers.Methods and analysisThe proposed integrated communication support programme is in the randomised control trial stage. It comprises a cluster of oncologists from comprehensive cancer centre hospitals in a metropolitan area in Japan. A total of 20 oncologists, 200 patients with advanced pancreatic cancer and the patients’ caregivers are enrolled in this study as of the writing of this protocol report. Oncologists are randomly assigned to the intervention group (IG) or control group (CG). Patients and caregivers are allocated to the same group as their oncologists. The IG oncologists receive a 2.5-hour individual communication skills training, and patients and caregivers receive a half-hour coaching intervention to facilitate prioritising and discussing questions and concerns; the CG participants do not receive any training. Follow-up data will be collected quarterly for 6 months for a year and then annually for up to 3 years. The primary endpoint is the intergroup difference between before-intervention and after-intervention patient-centred communication behaviours during oncology visits.Ethics and disseminationThis study is conducted in accordance with the ethical guidelines for clinical studies published by Japan’s Ministry of Education, Cultural, Sports, Science and Technology, the Ministry of Health, Labour and Welfare, and the ethical principles established for research on humans stipulated in the Declaration of Helsinki and further amendments thereto. The protocol was approved by the Institutional Review Board of National Cancer Center, Japan on 4 July 2018 (ID: 2017-474).Trial statusThis study is currently enrolling participants. Enrolment period ends 31 July 2020; estimated follow-up date is 31 March 2023.Trial registration numberUMIN Clinical Trial Registry (UMIN000033612); pre-results.

Objective Early integration of palliative and cancer care improves the quality of life and is facilitated by discussions about the end of life after cessation of active cancer treatment between patients with advanced cancer and their physicians. However, both patients and physicians find end-of-life discussions challenging. The aim of this study was to assess the need for a question prompt list (QPL) that encourages end-of-life discussions between patients with advanced cancer and their physicians. Methods Focus group interviews (FGIs) were conducted with 18 participants comprising 5 pancreatic cancer patients, 3 family caregivers, 4 bereaved family members, and 6 physicians. Three themes were discussed: question items that should be included in the QPL that encourages end-of-life discussions with patients, family caregivers, and physicians after cessation of active cancer treatment; when the QPL should be provided; and who should provide the QPL. Each interview was audio-recorded, and content analysis was performed. Results The following 9 categories, with 57 question items, emerged from the FGIs: (1) preparing for the end of life, (2) treatment decision-making, (3) current and future quality of life, (4) current and future symptom management, (5) information on the transition to palliative care services, (6) coping with cancer, (7) caregivers’ role, (8) psychological care, and (9) continuity of cancer care. Participants felt that the physician in charge of the patient's care and other medical staff should provide the QPL early during active cancer treatment. Significance of results Data were collected to develop a QPL that encourages end-of-life discussions between patients with advanced cancer and their physicians.

Assessing the need for a question prompt list that encourages end-of-life discussions between patients with advanced cancer and their physicians: A focus group interview study -ERRATUM.

Synaptic vesicle glycoprotein 2A (SV2A) is specifically expressed in synaptic vesicles and regulates neurotransmitter release at synapses. Recent studies reported a significant association of genetic SV2A polymorphism with schizophrenia (Schizophr. Res., 141, 262, 2012). We performed behavioral study using the SV2A-mutant rats, which carry a loss-of-function mutation (L174Q) in the Sv2a gene, to elucidate the effect of levetiracetam (LEV, a SV2A ligand) on methamphetamine (MAP)-induced hyperactivity in Sv2a L174Q rats. Acute treatments with MAP (1 mg/kg, i. p.) significantly increased locomotor activities in Sv2a L174Q rats, but not in control (F344) rats. The MAP-induced hyperactivity in Sv2a L174Q rats was weakly potentiated by LEV (30 mg/kg, i.p.). In F344 rats, LEV markedly potentiated MAP-induced hyperactivity to the extent similar to Sv2a L174Q rats. In addition, D 2 blocker, haloperidol (0.3 mg/kg, i.p.) completely suppressed the augmentation of MAP-induced hyperactivity by LEV in both Sv2a L174Q and F344 rats. The present results suggest that dysfunction of SV2A induces behavioral supersensitivity to MAP by increasing dopamine release, which may be linked to vulnerability against schizophrenia. Further, LEV reduces the function of SV2A, suggesting that LEV may exacerbate psychiatric symptoms.