Universitäts Spital Zürich, Rämistrasse 100, Zürich 8091, Switzerland.
Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett Street, Melbourne, Victoria 8066, Australia.
Eur J Cancer. 2020 Jul;133:120-130. doi: 10.1016/j.ejca.2020.04.010. Epub 2020 Jun 2.
Brentuximab vedotin was approved for adult patients with CD30-expressing cutaneous T-cell lymphoma treated with prior systemic therapy based on improved response rates and progression-free survival with brentuximab vedotin (1.8 mg/kg once every 3 weeks; ≤16 cycles) versus physician's choice (methotrexate/bexarotene; ≤48 weeks) in the phase III ALCANZA study. Quality of life (QoL) in ALCANZA patients was also examined.
QoL measures in ALCANZA were based on the Skindex-29, Functional Assessment of Cancer Therapy-General (FACT-G) and European QoL 5-dimension (EQ-5D) questionnaires.
Mean maximum reduction from the baseline Skindex-29 symptom domain score (key secondary end-point) was greater with brentuximab vedotin than physician's choice (-27.96 versus -8.62); the difference, -18.9 (95% confidence interval -26.6, -11.2; adjusted p < 0.001), exceeded the study-defined minimally important difference (9.0-12.3). Mean changes from baseline to end-of-treatment visit total FACT-G scores were similar with brentuximab vedotin and physician's choice (0.15 versus -2.29). EQ-5D changes were also comparable between arms. Among brentuximab vedotin-treated patients with peripheral neuropathy (PN), mean maximum reduction in Skindex-29 symptom domain was -35.54 versus -11.11 in patients without PN. PN had no meaningful effect on FACT-G and EQ-5D QoL scores.
In summary, brentuximab vedotin produced superior reductions in symptom burden compared with physician's choice, without adversely impacting QoL. QoL was unaffected by the presence of PN in brentuximab vedotin-treated patients.
NCT01578499.
基于贝林妥欧单抗(1.8mg/kg,每 3 周 1 次;最多 16 个周期)与医生选择(甲氨蝶呤/贝沙罗汀;最多 48 周)相比,在 III 期 ALCANZA 研究中,CD30 表达的皮肤 T 细胞淋巴瘤成人患者接受系统治疗后,贝林妥欧单抗治疗可提高缓解率和无进展生存期,因此获批用于该患者人群。ALCANZA 患者的生活质量(QoL)也进行了评估。
ALCANZA 中的 QoL 测量基于 Skindex-29、癌症治疗功能评估一般量表(FACT-G)和欧洲五维健康量表(EQ-5D)问卷。
与医生选择相比,贝林妥欧单抗的 Skindex-29 症状域评分(关键次要终点)从基线的最大平均降幅更大(-27.96 比-8.62);差异为-18.9(95%置信区间-26.6,-11.2;调整后 p<0.001),超过了研究定义的最小临床重要差值(9.0-12.3)。贝林妥欧单抗与医生选择的总 FACT-G 评分从基线到治疗结束的平均变化相似(0.15 比-2.29)。EQ-5D 变化在臂间也相似。在有周围神经病变(PN)的贝林妥欧单抗治疗患者中,Skindex-29 症状域的最大平均降幅为-35.54,而无 PN 的患者为-11.11。PN 对 FACT-G 和 EQ-5D QoL 评分没有明显影响。
总之,与医生选择相比,贝林妥欧单抗可显著减轻症状负担,而不会对 QoL 产生不利影响。在接受贝林妥欧单抗治疗的患者中,PN 的存在对 QoL 没有影响。
NCT01578499。