UCL Cancer Institute, London, UK.
Eur J Cancer. 2013 Nov;49(17):3648-57. doi: 10.1016/j.ejca.2013.07.144. Epub 2013 Aug 22.
In a recent randomised, double-blind, phase III clinical trial among 1195 patients with metastatic castration-resistant prostate cancer (mCRPC) who had failed docetaxel chemotherapy, abiraterone acetate was shown to significantly prolong overall survival compared with prednisone alone. Here we report on the impact of abiraterone therapy on the health-related quality of life (HRQoL) observed during this trial, assessed using the validated Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire.
All analyses were conducted using prespecified criteria for clinically meaningful improvement and deterioration in FACT-P total score as well as subscale scores; all respective thresholds were defined using an accepted methodology. Improvement was assessed only in patients with clinically significant functional status impairment at baseline.
Significant improvements in the FACT-P total score were observed in 48% of patients receiving abiraterone versus 32% of patients receiving prednisone (p < 0.0001). Also, the median time to deterioration in FACT-P total score was longer (p < 0.0001) in patients receiving abiraterone (59.9 weeks versus 36.1 weeks). Similar differences were observed in all FACT-P subscales, with the exception of the social/family well-being domain. Median time to improvement in the physical well-being domain and the trial outcome index was significantly shorter (p < 0.01) with abiraterone when compared with the prednisone arm.
The previously demonstrated survival benefit for abiraterone is accompanied by improvements in patient-reported HRQoL and a significant delay in HRQoL deterioration when compared with prednisone.
在最近一项针对 1195 名转移性去势抵抗性前列腺癌(mCRPC)患者的随机、双盲、III 期临床试验中,醋酸阿比特龙与单独使用泼尼松相比,显著延长了总生存期。在此,我们报告了在该试验中观察到的醋酸阿比特龙治疗对健康相关生活质量(HRQoL)的影响,使用经过验证的癌症治疗功能评估-前列腺(FACT-P)问卷进行评估。
所有分析均使用 FACT-P 总分及各亚量表评分的临床有意义改善和恶化的预设标准进行;所有相应的阈值均采用公认的方法定义。仅在基线时具有临床显著功能状态受损的患者中评估改善。
接受醋酸阿比特龙治疗的患者中有 48%观察到 FACT-P 总分显著改善,而接受泼尼松治疗的患者中仅有 32%(p<0.0001)。此外,接受醋酸阿比特龙治疗的患者 FACT-P 总分恶化的中位时间也更长(p<0.0001)(59.9 周对比 36.1 周)。在所有 FACT-P 亚量表中均观察到类似的差异,除了社会/家庭幸福感领域。与泼尼松组相比,接受醋酸阿比特龙治疗时,身体幸福感领域和试验结局指数的中位改善时间明显缩短(p<0.01)。
与泼尼松相比,醋酸阿比特龙在生存方面的显著获益,伴随患者报告的 HRQoL 的改善,以及 HRQoL 恶化的显著延迟。