Department of Dermatology, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany; The German Cancer Consortium, Heidelberg, Germany.
Division of Medical Oncology and Immunotherapy, Center for Immuno-Oncology, University Hospital of Siena, Banchi di Sotto, 55, 53100, Siena, SI, Italy.
Eur J Cancer. 2019 Dec;123:155-161. doi: 10.1016/j.ejca.2019.09.019. Epub 2019 Nov 5.
The aim of the study was to assess the impact of treatment with adjuvant vemurafenib monotherapy on health-related quality of life (HRQOL) in patients with resected stage IIC-IIIC melanoma.
The phase 3 BRIM8 study (NCT01667419) randomised patients with BRAF mutation-positive resected stage IIC-IIIC melanoma to 960 mg of vemurafenib twice daily or matching placebo for 52 weeks (13 × 28-day cycles). Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) version 3 at baseline, cycle 1 (days 1, 15 and 22), cycle 2 (days 1 and 15), day 1 of every subsequent 4-week cycle, the end-of-treatment visit and each visit during the follow-up period.
Completion rates for the EORTC QLQ-C30 questionnaire were high (>80%). There was a mean decline in the global health status (GHS)/quality of life (QOL) score of 17.4 (±22.9) and 17.3 (±24.1) points at days 15 and 22 of cycle 1, respectively, among vemurafenib-treated patients who recovered to approximately 10 points below baseline for the remainder of the treatment period. A similar trend was observed in all functional scales except for cognitive function (<10-point change from baseline at all visits) and in the symptom scores for appetite loss, fatigue and pain. As observed for the GHS/QOL score, all scores rapidly returned to baseline after completion of planned vemurafenib treatment or treatment discontinuation.
The schedule of HRQOL assessments allowed for an accurate and complete evaluation of the impact of acute treatment-related symptoms. Vemurafenib-treated patients experience clinically meaningful moderate worsening in some treatment- or disease-related symptoms and GHS/QOL that resolve over time.
本研究旨在评估辅助维莫非尼单药治疗对 BRAF 突变阳性可切除 IIIC 期黑色素瘤患者健康相关生活质量(HRQOL)的影响。
BRIM8 期研究(NCT01667419)将 BRAF 突变阳性可切除 IIIC 期黑色素瘤患者随机分为每天两次 960mg 维莫非尼组或匹配安慰剂组,治疗 52 周(13 个 28 天周期)。患者在基线、第 1 周期(第 1、15 和 22 天)、第 2 周期(第 1 天和第 15 天)、每个后续 4 周周期的第 1 天、治疗结束时和随访期间的每次就诊时完成欧洲癌症研究与治疗组织生活质量问卷核心 30 版(EORTC QLQ-C30)。
EORTC QLQ-C30 问卷的完成率较高(>80%)。维莫非尼治疗患者在第 1 周期第 15 天和第 22 天的全球健康状况(GHS)/生活质量(QOL)评分分别平均下降 17.4(±22.9)和 17.3(±24.1)分,在治疗期间其余时间恢复到基线以下约 10 分。在所有功能量表中,除认知功能(所有访视均较基线变化<10 分)和食欲下降、疲劳和疼痛症状评分外,观察到类似的趋势。与 GHS/QOL 评分一样,在完成计划的维莫非尼治疗或停药后,所有评分均迅速恢复到基线。
HRQOL 评估方案能够准确、全面地评估急性治疗相关症状的影响。维莫非尼治疗患者经历一些与治疗或疾病相关的症状和 GHS/QOL 的中度、有临床意义的恶化,这些症状随着时间的推移而缓解。