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LUME-Lung 1 试验患者报告结局分析:一项在晚期非小细胞肺癌患者中进行的二线尼达尼布随机、双盲、安慰剂对照 III 期研究

Analysis of patient-reported outcomes from the LUME-Lung 1 trial: a randomised, double-blind, placebo-controlled, Phase III study of second-line nintedanib in patients with advanced non-small cell lung cancer.

机构信息

Department of Oncology, University of Turin, Italy.

Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany.

出版信息

Eur J Cancer. 2015 Feb;51(3):317-26. doi: 10.1016/j.ejca.2014.11.015. Epub 2014 Dec 17.

DOI:10.1016/j.ejca.2014.11.015
PMID:25534294
Abstract

INTRODUCTION

The LUME-Lung 1 trial (NCT00805194; Study 1199.13) demonstrated a significant overall survival (OS) advantage for nintedanib plus docetaxel compared with placebo plus docetaxel as second-line therapy for patients with advanced non-small cell lung cancer (NSCLC) and adenocarcinoma histology. Patient-reported outcomes (PROs) for symptoms and health-related quality of life (QoL) are reported here.

METHODS

PROs were assessed at screening, on Day 1 of each 21-day treatment cycle, at the end of active treatment, and at the first follow-up visit. PRO instruments were the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Lung Cancer-13 supplement, and the EuroQol disease-generic questionnaire (EQ-5D and EQ-VAS). Analyses of PRO items for lung cancer-specific symptoms of cough, dyspnoea and pain were prespecified.

RESULTS

Rates of questionnaire completion were high. There was no significant difference in time to deterioration of global health status/QoL, or symptoms of cough, dyspnoea or pain, between the treatment groups for both the overall study population and the adenocarcinoma population. Time to deterioration of some gastrointestinal events was shorter with nintedanib versus placebo. Longitudinal analysis for the adenocarcinoma population showed comparable changes between the groups in symptom scores over time, with numerical differences in favour of nintedanib for cough and pain scales, and significant reductions in some pain items with nintedanib versus placebo. There was no statistically significant difference in EQ-5D or EQ-VAS between the groups.

CONCLUSION

The significant OS benefit observed with the addition of nintedanib to docetaxel therapy was achieved with no detrimental effect on patient self-reported QoL.

摘要

简介

LUME-Lung 1 试验(NCT00805194;研究 1199.13)表明,尼达尼布联合多西他赛二线治疗晚期非小细胞肺癌(NSCLC)和腺癌患者的总生存期(OS)显著优于安慰剂联合多西他赛。本文报告患者报告的结局(PROs),包括症状和健康相关生活质量(QoL)。

方法

在筛选时、每个 21 天治疗周期的第 1 天、主动治疗结束时和第一次随访时评估 PRO。PRO 工具包括欧洲癌症研究与治疗组织生活质量问卷 C30 和肺癌 13 补充问卷,以及欧洲五维健康量表(EQ-5D)和 EQ 视觉模拟量表(EQ-VAS)。对肺癌特异性症状(咳嗽、呼吸困难和疼痛)的 PRO 项目进行了预设分析。

结果

问卷完成率很高。在整个研究人群和腺癌人群中,尼达尼布与安慰剂组之间,全球健康状况/生活质量恶化的时间、咳嗽、呼吸困难或疼痛症状无显著差异。与安慰剂相比,尼达尼布组出现某些胃肠道事件恶化的时间更早。对于腺癌人群,随着时间的推移,两组间症状评分的纵向分析显示,尼达尼布组在咳嗽和疼痛量表上的数值差异有利于尼达尼布,而与安慰剂相比,尼达尼布组在某些疼痛项目上有显著减少。两组间在 EQ-5D 或 EQ-VAS 上无统计学差异。

结论

在多西他赛治疗中加入尼达尼布观察到的显著 OS 获益,没有对患者自我报告的 QoL 产生不利影响。

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