Jenkins2018_Article_DoDrugsOfferingOnlyPFSMaintain.pdf (938.91 kB)
Do drugs offering only PFS maintain quality of life sufficiently from a patient’s perspective? Results from AVALPROFS (Assessing the ‘VALue’ to patients of PROgression Free Survival) study
Version 2 2023-06-12, 08:54
Version 1 2023-06-09, 13:20
journal contribution
posted on 2023-06-12, 08:54 authored by Valerie JenkinsValerie Jenkins, V Farewell, Shirley May, Susan Catt, L Matthews, Valerie ShillingValerie Shilling, J Dickson, R Simcock, Lesley FallowfieldLesley FallowfieldPurpose: Trials of novel drugs used in advanced disease often show only progression free survival or modest overall survival benefits. Hypothetical studies suggest that stabilisation of metastatic disease and/or symptom burden are worth treatment-related side-effects. We examined this premise contemporaneously using qualitative and quantitative methods. Methods: Patients with metastatic cancers expected to live >6 months and prescribed drugs aimed at cancer control, were interviewed: - at baseline, 6 weeks, at progression and if treatment was stopped for toxicity. They also completed Functional Assessment of Cancer Therapy (FACT-G) plus Anti-Angiogenesis (AA) subscale questionnaires at baseline then monthly for 6 months. Results: 90/120 (75%) eligible patients participated: 41 (45%) remained on study for 6 months, 36 progressed or died, 4 had treatment breaks and 9 withdrew due to toxicity. By 6 weeks, 66/69 (96%) patients were experiencing side-effects which impacted their activities. Low QoL scores at baseline did not predict a higher risk of death or drop out. At 6 week interviews, as the side effect severity increased, patients were significantly less inclined to view the benefit of cancer control as worthwhile (X2=50.7 P < 0.001). Emotional well-being initially improved from baseline by 10 weeks, then gradually returned to baseline levels. Conclusion: Maintaining QoL is vital to most patients with advanced cancer so minimising treatment related side-effects is essential. As side-effect severity increased, drugs that controlled cancer for short periods were not viewed as worthwhile. Patients need to have the therapeutic aims of further anti-cancer treatment explained honestly and sensitively.
Funding
AVALPROFS; Boehringer Ingelheim
History
Publication status
- Published
File Version
- Published version
Journal
Supportive Care in CancerISSN
0941-4355Publisher
Springer VerlagExternal DOI
Issue
11Volume
26Page range
3941-3949Department affiliated with
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C) Publications
Research groups affiliated with
- Sussex Health Outcomes Research and Education in Cancer Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2018-05-17First Open Access (FOA) Date
2018-06-27First Compliant Deposit (FCD) Date
2018-05-16Usage metrics
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