Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA.
Clin Genitourin Cancer. 2013 Jun;11(2):149-54. doi: 10.1016/j.clgc.2012.09.006. Epub 2012 Oct 9.
An emerging literature describes the potential for long-term survival with targeted agents, but the health-related quality of life (HR-QOL) in patients who receive chronic therapy with these agents is poorly defined.
From an institutional database including 562 patients with renal cell carcinoma (RCC), patients were identified who (1) were alive 3 years beyond initiation of systemic therapy for metastatic renal cell carcinoma (mRCC) and (2) received a targeted therapy as a component of their treatment. European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 36 (QLQ-C30) and Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-15) questionnaires were administered by telephone survey. Data from questionnaires were compared with historical estimates derived from pivotal studies evaluating targeted agents.
A total of 38 patients met eligibility criteria for the study, and 28 patients participated in the telephone survey. Most were male patients and had clear cell histologic type (75% for both). All patients had either good- or intermediate-risk disease by Heng criteria. The mean QLQ-C30 Global QOL score in the present cohort was higher than the mean score among patients evaluated at baseline in the phase III evaluations of pazopanib (73.5 vs. 65.8; P = .07) and everolimus (73.5 vs. 61.0; P = .007). The FKSI-15 score in the present cohort was similar to the mean score among patients evaluated at baseline in the phase III evaluation of sunitinib (45.1 and 46.5, respectively; P = .41).
In this small pilot study, long-term survivors with mRCC who received targeted therapies appear to have an HR-QOL comparable to that of patients who participated in relevant phase III studies. Given the many emerging treatment options for mRCC, the HR-QOL of long-term survivors warrants greater attention.
越来越多的文献描述了靶向药物治疗具有长期生存的潜力,但接受这些药物进行慢性治疗的患者的健康相关生活质量(HR-QOL)却定义不明确。
从一个包括 562 例肾细胞癌(RCC)患者的机构数据库中,确定了以下患者:(1)在接受转移性肾细胞癌(mRCC)系统治疗后 3 年仍存活;(2)在治疗中接受了靶向治疗。通过电话调查,对欧洲癌症研究与治疗组织(EORTC)核心 36 项生活质量问卷(QLQ-C30)和癌症治疗功能评估-肾症状指数(FKSI-15)问卷进行了评估。对问卷数据与评估靶向药物的关键研究中得出的历史估计值进行了比较。
共有 38 例患者符合研究纳入标准,其中 28 例患者参与了电话调查。大多数患者为男性,且组织学类型为透明细胞型(两者均为 75%)。根据 Heng 标准,所有患者均为中危或高危疾病。本队列的 QLQ-C30 全球 QOL 评分均值高于 pazopanib 三期评估时基线患者的评分均值(73.5 比 65.8;P=0.07)和 everolimus 三期评估时基线患者的评分均值(73.5 比 61.0;P=0.007)。本队列的 FKSI-15 评分与舒尼替尼三期评估时基线患者的评分均值相似(分别为 45.1 和 46.5;P=0.41)。
在这项小型试点研究中,接受靶向治疗的 mRCC 长期生存者的 HR-QOL 似乎与参加相关三期研究的患者相当。鉴于 mRCC 有许多新的治疗选择,长期生存者的 HR-QOL 需要引起更多关注。