Department of Surgery, Osaka General Medical Center, 3-1-56, Bandaihigashi, Sumiyoshi-ku, Osaka, 558-0056, Japan.
Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Gastric Cancer. 2021 Mar;24(2):467-476. doi: 10.1007/s10120-020-01131-y. Epub 2020 Nov 2.
This study evaluated the association between early tumor response at 8 weeks, previously reported as a positive outcome prognosticator, and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients enrolled in the ABSOLUTE trial.
HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D) utility index score in patients with complete response (CR) + partial response (PR) and progressive disease (PD) at 8 weeks, and time-to-deterioration (TtD) of the EQ-5D score, with the preset minimally important difference (MID) of 0.05, was compared between these populations. Among the enrolled patients, 143 and 160 patients were assessable in weekly solvent-based paclitaxel (Sb-PTX) arm and weekly nanoparticle albumin-bound paclitaxel (nab-PTX) arm, respectively.
Changes of the EQ-5D score from baseline to 8 weeks in the nab-PTX arm were 0.0009 and - 0.1229 in CR + PR and PD patients, respectively; the corresponding values for the Sb-PTX arm were - 0.0019 and - 0.1549. For both treatments, changes of the EQ-5D score from baseline at 8 weeks were significantly larger in patients with PD than in those with CR + PR. The median TtD was 3.9 and 2.2 months in patients with CR + PR and PD, respectively, for nab-PTX [hazard ratio (HR) = 0.595, 95% confidence interval (CI) 0.358-0.989]. For Sb-PTX, the corresponding values were 4.7 and 2.0 months (HR = 0.494, 95% CI 0.291-0.841).
Early tumor shrinkage was associated with maintained HRQOL in AGC patients on the second-line chemotherapy with taxanes.
本研究评估了在 ABSOLUTE 试验中,8 周时的早期肿瘤应答(先前报道为阳性预后预测因子)与晚期胃癌(AGC)患者的健康相关生活质量(HRQOL)之间的关联。
使用 EuroQol-5 维度(EQ-5D)效用指数评分评估具有完全缓解(CR)+部分缓解(PR)和 8 周时进展性疾病(PD)的患者的 HRQOL,以及 EQ-5D 评分的恶化时间(TtD),并与 0.05 的预设最小重要差异(MID)进行比较。在纳入的患者中,每周溶剂型紫杉醇(Sb-PTX)组和每周纳米白蛋白结合紫杉醇(nab-PTX)组分别有 143 例和 160 例可评估。
nab-PTX 组 CR+PR 和 PD 患者的 EQ-5D 评分从基线到 8 周的变化分别为 0.0009 和-0.1229,Sb-PTX 组的相应值分别为-0.0019 和-0.1549。对于两种治疗方法,从基线开始,8 周时 PD 患者的 EQ-5D 评分变化明显大于 CR+PR 患者。nab-PTX 治疗组 CR+PR 和 PD 患者的中位 TtD 分别为 3.9 和 2.2 个月(nab-PTX 风险比(HR)=0.595,95%置信区间(CI)0.358-0.989)。对于 Sb-PTX,相应的值分别为 4.7 和 2.0 个月(HR=0.494,95%CI 0.291-0.841)。
在接受紫杉醇二线化疗的 AGC 患者中,早期肿瘤缩小与 HRQOL 保持相关。