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一项开放性标签安全性和疗效研究的长期患者报告结局,该研究评估了达沙替尼治疗费城染色体阳性慢性髓性白血病患者的疗效和安全性。

Long-term patient-reported outcomes from an open-label safety and efficacy study of bosutinib in Philadelphia chromosome-positive chronic myeloid leukemia patients resistant or intolerant to prior therapy.

机构信息

The University of Texas MD Anderson Cancer Center, Houston, Texas.

Pfizer Inc, Groton, Connecticut.

出版信息

Cancer. 2018 Feb 1;124(3):587-595. doi: 10.1002/cncr.31082. Epub 2017 Oct 26.

Abstract

BACKGROUND

Health-related quality of life (HRQOL) in patients with chronic-phase chronic myeloid leukemia (CML) is important because of the requirement for long-term treatment. This study assessed HRQOL in bosutinib-treated patients with Philadelphia chromosome-positive CML and resistance or intolerance to 1 (chronic-phase second-line [CP2L]) or more (chronic-phase third-line [CP3L]) tyrosine kinase inhibitors who had 264 weeks or more of follow-up (ClinicalTrials.gov identifier NCT00261846).

METHODS

Patient-reported HRQOL was assessed with the EuroQol 5-Dimensions Questionnaire (EQ-5D) and the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu).

RESULTS

In total, 284 and 119 patients composed the CP2L and CP3L cohorts, respectively. At treatment completion, more than 50% of the patients in the CP2L and CP3L cohorts completed the EQ-5D and FACT-Leu assessments. The EQ-5D and EQ-5D visual analog scale scores were stable in both cohorts throughout treatment. The mean FACT-Leu scores were generally stable over time but were lower in magnitude in the CP3L cohort versus the CP2L cohort. The FACT-Leu scale scores of a subset of patients with chronic diarrhea (CP2L, n = 101; CP3L, n = 30) were similar to the scores of the larger cohorts. Minimally important differences (MIDs) from baseline for the FACT-Leu scale scores were observed for the following: emotional well-being (EWB), Functional Assessment of Cancer Therapy-General (FACT-G) Total, FACT-Leu Total, and Functional Assessment of Cancer Therapy Trial Outcome Index (FACT-TOI) in the CP2L cohort and FACT-Leu Total in the CP3L cohort. Among patients with chronic diarrhea, MIDs were observed for EWB, FACT-G Total, FACT-Leu Total, and FACT-TOI in the CP2L cohort and for EWB, FACT-G Total, and FACT-Leu Total in the CP3L cohort.

CONCLUSIONS

HRQOL was maintained with long-term bosutinib treatment for patients with CP2L and CP3L CML. Cancer 2018;124:587-95. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

摘要

背景

由于需要长期治疗,慢性期慢性髓性白血病(CML)患者的健康相关生活质量(HRQOL)很重要。这项研究评估了接受博舒替尼治疗的费城染色体阳性 CML 患者的 HRQOL,这些患者对 1 种(慢性期二线[CP2L])或更多(慢性期三线[CP3L])酪氨酸激酶抑制剂具有耐药性或不耐受性,且随访时间达到 264 周或更长时间(ClinicalTrials.gov 标识符:NCT00261846)。

方法

使用欧洲五维健康量表(EQ-5D)和癌症治疗功能评估-白血病量表(FACT-Leu)评估患者报告的 HRQOL。

结果

CP2L 和 CP3L 队列分别有 284 例和 119 例患者。在治疗结束时,CP2L 和 CP3L 队列中超过 50%的患者完成了 EQ-5D 和 FACT-Leu 评估。在整个治疗过程中,CP2L 和 CP3L 队列的 EQ-5D 和 EQ-5D 视觉模拟评分均保持稳定。FACT-Leu 评分在一段时间内通常保持稳定,但 CP3L 队列的评分幅度低于 CP2L 队列。CP2L(n=101)和 CP3L(n=30)慢性腹泻患者亚组的 FACT-Leu 量表评分与更大队列的评分相似。CP2L 队列中,FACT-Leu 量表的最小临床重要差异(MID)可观察到:情感健康(EWB)、癌症治疗功能评估-一般(FACT-G)总分、FACT-Leu 总分和癌症治疗临床试验结局指数(FACT-TOI),CP3L 队列中,FACT-Leu 总分的 MID 也可观察到。在慢性腹泻患者中,CP2L 队列的 EWB、FACT-G 总分、FACT-Leu 总分和 FACT-TOI,以及 CP3L 队列的 EWB、FACT-G 总分和 FACT-Leu 总分的 MID 也可观察到。

结论

CP2L 和 CP3L CML 患者接受博舒替尼长期治疗,其 HRQOL 得以维持。癌症 2018;124:587-95。© 2017 美国癌症协会。这是在知识共享署名-非商业许可下的许可条款下发布的,该许可允许在任何媒介中不受限制地使用、发布和复制,前提是原始作品正确引用且不用于商业目的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dd2/5813200/0dd54792b960/CNCR-124-587-g001.jpg

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