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29.05.2018 | Original Article | Ausgabe 11/2018 Open Access

Supportive Care in Cancer 11/2018

Do drugs offering only PFS maintain quality of life sufficiently from a patient’s perspective? Results from AVALPROFS (Assessing the ‘VALue’ to patients of PROgression Free Survival) study

Zeitschrift:
Supportive Care in Cancer > Ausgabe 11/2018
Autoren:
V. Jenkins, V. Farewell, S. May, S. Catt, L. Matthews, V. Shilling, J. Dickson, R. Simcock, L. Fallowfield
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00520-018-4273-3) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Trials of novel drugs used in advanced disease often show only progression-free survival or modest overall survival benefits. Hypothetical studies suggest that stabilisation of metastatic disease and/or symptom burden are worth treatment-related side effects. We examined this premise contemporaneously using qualitative and quantitative methods.

Methods

Patients with metastatic cancers expected to live > 6 months and prescribed drugs aimed at cancer control were interviewed: at baseline, at 6 weeks, at progression, and if treatment was stopped for toxicity. They also completed Functional Assessment of Cancer Therapy (FACT-G) plus Anti-Angiogenesis (AA) subscale questionnaires at baseline then monthly for 6 months.

Results

Ninety out of 120 (75%) eligible patients participated: 41 (45%) remained on study for 6 months, 36 progressed or died, 4 had treatment breaks, and 9 withdrew due to toxicity. By 6 weeks, 66/69 (96%) patients were experiencing side effects which impacted their activities. Low QoL scores at baseline did not predict a higher risk of death or dropout. At 6-week interviews, as the side effect severity increased, patients were significantly less inclined to view the benefit of cancer control as worthwhile (X2 = 50.7, P < 0.001). Emotional well-being initially improved from baseline by 10 weeks, then gradually returned to baseline levels.

Conclusion

Maintaining QoL is vital to most patients with advanced cancer so minimising treatment-related side effects is essential. As side effect severity increased, drugs that controlled cancer for short periods were not viewed as worthwhile. Patients need to have the therapeutic aims of further anti-cancer treatment explained honestly and sensitively.

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Zusatzmaterial
Supplementary Table 1 (DOCX 20 kb)
520_2018_4273_MOESM1_ESM.docx
ESM 1 (DOCX 20 kb)
520_2018_4273_MOESM2_ESM.docx
ESM 2 (DOCX 165 kb)
520_2018_4273_MOESM3_ESM.docx
ESM 3 (DOCX 132 kb)
520_2018_4273_MOESM4_ESM.docx
Literatur
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