Niraparib (Zejula) Survivor Survey 2019

We understand that Glaxo Smith Kline will be applying to CADTH's pan-Canadian Oncology Drug Review (pCODR) to seek a funding recommendation for the use of Niraparib (Zejula) as maintenance treatment for those who have platinum-sensitive, recurrent, epithelial ovarian, fallopian tube or primary peritoneal cancer.

Please note, for the purpose of this survey, epithelial ovarian, fallopian tube or primary peritoneal cancer will be referred to as ovarian cancer.

The experiences of people who have been diagnosed with ovarian cancer are important considerations in the drug funding approval process. Ovarian Cancer Canada has prepared this survey to gather information from those individuals diagnosed with ovarian cancer so that your experiences can be included in the decision-making process.

There are certain requirements for filling out this survey because the drug is only being considered for treatment of particular indications. We recognize that everyone’s input is important, however for this submission, only those who fit the profile can fill out the survey. If you do not fit the profile and still want to share your story, please contact Marilyn Sapsford at msapsford@ovariancanada.org.

Those eligible to fill out this survey are those who have:

1)  been diagnosed with epithelial ovarian, fallopian tube or primary peritoneal cancer; AND
2)  been treated with platinum based chemotherapy; AND
3)  had at least one recurrence; AND
4)  the recurrence happened at least six months after the end of chemotherapy treatment; AND
5)  may or may not have taken Niraparib.

In this survey, the word 'treatment' refers to any treatment received including chemotherapy drugs and/or other drugs, surgery, radiation, etc.

When compiling this submission, we may use 'quotes', however, no names will be used that could reveal your identity.

If you are not familiar with Niraparib (Zejula) it would be helpful to review some information in advance of completing this survey. Information about Niraparib (Zejula) and related side effects can be found on-line at: http://www.cancerresearchuk.org.

This survey should take approximately 15 minutes to complete. Thank you for your assistance.

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