Department of Medicine, University of California-San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States.
Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.
Oncologist. 2024 Sep 6;29(9):768-779. doi: 10.1093/oncolo/oyae088.
The TROPiCS-02 study (NCT03901339) demonstrated that sacituzumab govitecan (SG) has superior clinical outcomes over treatment of physician's choice (TPC) chemotherapy in patients with hormone receptor-positive, human epidermal growth factor 2 receptor-negative (HR+/HER2-) metastatic breast cancer (mBC). Here, we present health-related quality of life (HRQoL) patient-reported outcome (PRO) findings from this study.
Eligible adults with HR+/HER2- mBC who previously received a taxane, endocrine-based therapy, a CDK4/6 inhibitor, and 2-4 lines of chemotherapy were randomized 1:1 to receive SG or TPC until progression or unacceptable toxicity. PROs were assessed at baseline and on day 1 of each cycle, using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 (EORTC QLQ-C30), EQ-5D-5L, and PRO Common Terminology Criteria for Adverse Events (PRO-CTCAE).
Compared to TPC, overall least square mean change from baseline was significantly better for SG for physical functioning and dyspnea, but worse for diarrhea. Time to first clinically meaningful worsening or death was significantly longer for SG in global health status/quality of life, physical functioning, fatigue, emotional functioning, dyspnea, insomnia, and financial difficulties of the EORTC QLQ-C30 and the EQ-VAS, but longer for TPC in diarrhea. Few patients in both arms reported experiencing any worsening to level 3 or 4 treatment-related symptomatic events during treatment, as assessed by 16 PRO-CTCAE items, except for diarrhea frequency and amount of hair loss, which favored TPC.
SG was associated with an HRQoL benefit in most symptoms and functioning, compared with TPC. This supports the favorable profile of SG as a treatment option for patients with pretreated HR+/HER2- mBC.
TROPiCS-02 研究(NCT03901339)表明,在激素受体阳性、人表皮生长因子 2 受体阴性(HR+/HER2-)转移性乳腺癌(mBC)患者中,与医生选择的治疗(TPC)化疗相比,注射用Sacituzumab govitecan(SG)具有更优的临床结局。在此,我们报告了这项研究的健康相关生活质量(HRQoL)患者报告结局(PRO)发现。
符合条件的 HR+/HER2-mBC 成年患者,既往接受过紫杉烷、内分泌治疗、CDK4/6 抑制剂和 2-4 线化疗,按 1:1 比例随机分配至 SG 组或 TPC 组,直至疾病进展或不可接受的毒性。使用欧洲癌症研究与治疗组织生活质量核心 30 问卷(EORTC QLQ-C30)、EQ-5D-5L 和患者报告结局通用术语标准不良事件(PRO-CTCAE)在基线和每个周期第 1 天评估 PRO。
与 TPC 相比,SG 组从基线开始的身体功能和呼吸困难的最小二乘均数变化总体上明显更好,但腹泻更差。在 EORTC QLQ-C30 和 EQ-VAS 的全球健康状况/生活质量、身体功能、疲劳、情绪功能、呼吸困难、失眠和经济困难方面,SG 组首次临床意义上恶化或死亡的时间明显更长,而 TPC 组在腹泻方面首次临床意义上恶化或死亡的时间明显更长。在接受治疗的过程中,很少有患者报告发生任何 16 个 PRO-CTCAE 项目中任何一项治疗相关症状事件恶化至 3 级或 4 级,除腹泻频率和脱发量外,这两项指标对 TPC 更有利。
与 TPC 相比,SG 与大多数症状和功能的 HRQoL 获益相关。这支持了 SG 作为治疗预处理 HR+/HER2-mBC 患者的一种治疗选择的有利特征。