EMPOWER CERVICAL-1:西妥昔单抗对比化疗对复发性宫颈癌患者报告的生活质量、功能和症状的影响。
EMPOWER CERVICAL-1: Effects of cemiplimab versus chemotherapy on patient-reported quality of life, functioning and symptoms among women with recurrent cervical cancer.
机构信息
Gynaecologic Cancer Programme, Vall D'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall D'Hebron, Vall D'Hebron Barcelona Hospital Campus, Barcelona, Spain.
Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), University of Arizona, Creighton University, Phoenix, AZ, USA.
出版信息
Eur J Cancer. 2022 Oct;174:299-309. doi: 10.1016/j.ejca.2022.03.016. Epub 2022 Jul 31.
BACKGROUND
In a phase III, randomised, active-controlled study (EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9; R2810-ONC-1676; NCT03257267) and cemiplimab significantly improved survival versus investigator's choice of chemotherapy among patients with recurrent cervical cancer who had progressed on platinum-based therapy. Here we report patient-reported outcomes in this pivotal study.
METHODS
Patients were randomised 1:1 to open-label cemiplimab (350 mg intravenously every 3 weeks) or investigator's choice of chemotherapy in 6-week cycles. Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 during cycles 1-16. Least-squares mean changes from baseline in global health status (GHS)/quality of life (QoL) and physical functioning (PF) were secondary end-points in the statistical hierarchy.
RESULTS
Of 608 patients (304/arm), 77.8% patients had squamous cell carcinoma and 22.2% patients had adenocarcinoma. Questionnaire completion rates were ∼90% throughout. In the squamous cell carcinoma population, overall between-group differences statistically significantly favoured cemiplimab in GHS/QoL (8.49; 95% confidence interval [CI]: 3.77-13.21; P = 0.0003) and PF (8.35; 95% CI: 4.08-12.62; P < 0.0001). Treatment differences favoured cemiplimab in both histologic populations by cycle 2. Overall changes from baseline in most functioning and symptom scales favoured cemiplimab, with clinically meaningful treatment differences in role functioning, appetite loss and pain in both populations. The sensitivity analyses, responder analyses and time to definitive deterioration favoured cemiplimab in both populations.
CONCLUSIONS
Cemiplimab conferred favourable differences in GHS/QoL and PF compared with chemotherapy among patients with recurrent cervical cancer, with benefits in PF by cycle 2, and clinically meaningful differences favouring cemiplimab in role functioning, appetite loss, and pain.
背景
在一项 III 期、随机、阳性对照研究(EMPOWER-Cervical 1/GOG-3016/ENGOT-cx9;R2810-ONC-1676;NCT03257267)中,与接受铂类为基础的治疗后进展的复发性宫颈癌患者的研究者选择的化疗相比,西米普利单抗显著改善了生存。在这里,我们报告了这项关键研究中的患者报告结果。
方法
患者按 1:1 比例随机分配至开放标签西米普利单抗(350mg 静脉注射,每 3 周一次)或研究者选择的化疗,每 6 周为一个周期。患者在第 1-16 周期完成欧洲癌症研究与治疗组织生活质量问卷核心 30。从基线的最小二乘均数变化是次要终点。
结果
在 608 例患者中(每组 304 例),77.8%患者为鳞状细胞癌,22.2%患者为腺癌。整个过程中问卷完成率约为 90%。在鳞状细胞癌人群中,总体组间差异在全球健康状况(GHS)/生活质量(QoL)和身体功能(PF)方面均明显有利于西米普利单抗(8.49;95%置信区间 [CI]:3.77-13.21;P=0.0003)和 PF(8.35;95% CI:4.08-12.62;P < 0.0001)。在第 2 个周期,两种组织学人群均显示治疗差异有利于西米普利单抗。大多数功能和症状量表的基线总体变化有利于西米普利单抗,两种人群在角色功能、食欲减退和疼痛方面均具有有临床意义的治疗差异。敏感性分析、应答者分析和明确恶化的时间都有利于两种人群中的西米普利单抗。
结论
与复发性宫颈癌患者的化疗相比,西米普利单抗在 GHS/QoL 和 PF 方面表现出有利的差异,PF 在第 2 个周期时具有优势,在角色功能、食欲减退和疼痛方面具有有临床意义的治疗差异。