Abstract
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. Patients with metastatic cancers expected to live > 6 months and prescribed drugs aimed at cancer control were interviewed: at baseline, at 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. Ninety out of 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 dropout. 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). Em...Continue Reading
References
Mar 1, 1993·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·D F CellaJ Brannon
Mar 9, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Roy S HerbstAlan Sandler
Oct 18, 2006·Annals of Oncology : Official Journal of the European Society for Medical Oncology·P C Stone, S Lund
Aug 2, 2008·BMJ : British Medical Journal·Suzanne AudreyRona Campbell
Nov 19, 2009·Journal of the National Cancer Institute·Ethan BaschDeborah Schrag
Sep 8, 2010·The New England Journal of Medicine·Jennifer S TemelThomas J Lynch
Jan 26, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeffrey M PeppercornUNKNOWN American Society of Clinical Oncology
Oct 20, 2011·Nature Reviews. Clinical Oncology·Lesley J Fallowfield, Anne Fleissig
Nov 26, 2011·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Eitan AmirAlberto Ocaña
Mar 1, 2012·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·John F P BridgesA Brett Hauber
Mar 1, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Christopher M Booth, Elizabeth A Eisenhauer
Jul 18, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Saroj NiraulaEitan Amir
Nov 8, 2012·Cancer·David HuiEduardo Bruera
Aug 22, 2013·PharmacoEconomics·Alan CarlottoStephen T Sonis
Jan 27, 2015·Cancer Medicine·Karen KaiserDavid Cella
Jul 24, 2015·JAMA Oncology·Holly G PrigersonPaul K Maciejewski
Oct 7, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Andrea C EnzingerHolly G Prigerson
Oct 5, 2016·BMJ : British Medical Journal·Neil LineberryChristine Laine
Jun 13, 2017·The Cochrane Database of Systematic Reviews·Markus W HaunMechthild Hartmann
Oct 6, 2017·BMJ : British Medical Journal·Courtney DavisAjay Aggarwal
Citations
Nov 28, 2018·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J BrandtK Jordan
Sep 27, 2019·JAMA Oncology·Michael J RaphaelMichael Brundage
Nov 26, 2019·PloS One·May SudhinarasetZiporah Mugwanga
Mar 11, 2020·JAMA Network Open·Norbert MarschnerMartina Jänicke
Sep 20, 2019·BMJ : British Medical Journal·Huseyin NaciChristopher M Booth
Jan 29, 2020·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J BrandtK Jordan