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观察性研究评估接受依维莫司治疗的胰腺神经内分泌肿瘤患者的生活质量:OBLIQUE 研究(英国四期试验)。

Observational Study to Assess Quality of Life in Patients with Pancreatic Neuroendocrine Tumors Receiving Treatment with Everolimus: The OBLIQUE Study (UK Phase IV Trial).

机构信息

Kings College Hospital, London and Hampshire Hospitals, London, United Kingdom,

Queen Elizabeth Hospital, Birmingham, United Kingdom.

出版信息

Neuroendocrinology. 2019;108(4):317-327. doi: 10.1159/000497330. Epub 2019 Jan 30.

Abstract

BACKGROUND/AIMS: To assess health-related quality of life (HRQoL), treatment patterns, and clinical outcomes of adult (≥18 years) patients with advanced (unresectable or metastatic) pancreatic neuroendocrine neoplasms (PanNENs) treated with everolimus in routine clinical practice.

METHODS

In a prospective, non-interventional, multi-center study patients administered at least one 10 mg dose of everolimus were evaluated for change in HRQoL (EORTC QLQ-C30 Global Health Status scale) from baseline after 6 months treatment (primary endpoint). Secondary endpoints included disease-specific HRQoL measures (EORTC QLQ-G.I.NET21), clinical outcomes, everolimus treatment patterns, and safety.

RESULTS

Forty-eight patients were recruited (between August 2013 and March 2015); the median treatment duration was 27.8 months. EORTC QLQ-C30 Global Health score was not significantly different from baseline after 6 months of treatment (mean difference -1.9 points, p = 0.660, n = 30). In pairwise analyses, the only significant changes in HRQoL from baseline were for EORTC QLQ-C30 physical functioning score at month 3 (adjusted mean difference -8.8 points, p = 0.002, n = 36) and the EORTC QLQ-G.I.NET21 disease-related worries scores at months 1 and 2 (adjusted mean differences: -11.5 points [p = 0.001, n = 44] and -8.8 points [p = 0.017, n = 43], respectively). Disease progression or death was recorded in 44.4% (n = 20/45) patients during follow-up; median progression-free survival was 25.1 months and the cumulative survival rate at 3 years was 71%. No new safety signals were detected.

CONCLUSIONS

The OBLIQUE study demonstrates that HRQoL is maintained in patients with PanNENs during treatment with everolimus in a UK real-world setting. This study adds to the limited HRQoL data available in this patient group.

摘要

背景/目的:评估接受依维莫司治疗的成人(≥18 岁)晚期(不可切除或转移性)胰腺神经内分泌肿瘤(PanNENs)患者的健康相关生活质量(HRQoL)、治疗模式和临床结局。

方法

在一项前瞻性、非干预性、多中心研究中,对至少接受过一次 10mg 剂量依维莫司治疗的患者进行评估,以评估治疗 6 个月后 HRQoL(EORTC QLQ-C30 全球健康状况量表)的变化(主要终点)。次要终点包括疾病特异性 HRQoL 指标(EORTC QLQ-G.I.NET21)、临床结局、依维莫司治疗模式和安全性。

结果

共招募了 48 例患者(2013 年 8 月至 2015 年 3 月);中位治疗持续时间为 27.8 个月。治疗 6 个月后,EORTC QLQ-C30 全球健康评分与基线相比无显著差异(平均差值-1.9 分,p = 0.660,n = 30)。在两两分析中,与基线相比,HRQoL 唯一显著变化的是 EORTC QLQ-C30 身体功能评分在第 3 个月(调整平均差值-8.8 分,p = 0.002,n = 36)和 EORTC QLQ-G.I.NET21 疾病相关担忧评分在第 1 个月和第 2 个月(调整平均差值:-11.5 分[ p = 0.001,n = 44]和-8.8 分[ p = 0.017,n = 43])。在随访期间,44.4%(n = 20/45)的患者记录到疾病进展或死亡;中位无进展生存期为 25.1 个月,3 年累积生存率为 71%。未发现新的安全信号。

结论

OBLIQUE 研究表明,在英国真实环境中,依维莫司治疗 PanNENs 患者的 HRQoL 得到维持。这项研究增加了这一患者群体中有限的 HRQoL 数据。

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