Q-TWiST analysis to estimate overall benefit for patients with metastatic renal cell carcinoma treated in a phase III trial of sunitinib vs interferon-α.

British Journal of Cancer
Sujata PatilRobert J Motzer

Abstract

In a randomised phase III trial of treatment-naive patients with metastatic renal cell carcinoma, sunitinib showed significant improvement in progression-free survival (PFS) compared with interferon (IFN)-α. We assessed between-treatment differences in overall benefit using a quality-adjusted Time Without Symptoms of disease progression or Toxicity of treatment (TWiST; Gelber and Goldhirsch) analysis. In this analysis, in which only grade 3/4 treatment-related toxicities were included, overall survival was partitioned into three health states: toxicity (time with toxicity after randomisation and before progression), time without symptoms of disease progression or toxicity, and time from progression until death. Between-treatment differences in the mean duration of each state were calculated. A threshold utility analysis was used to assess quality-adjusted TWiST (Q-TWiST) outcomes. Q-TWiST scores showed that quality-adjusted survival time was greater with sunitinib than with IFN-α, even though certain grade 3/4 toxicities occurred more frequently with sunitinib. For both treatments, the mean number of days with toxicity was small compared with PFS. This effect was more pronounced with sunitinib in which time spent without progre...Continue Reading

References

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Citations

Oct 2, 2012·Therapeutic Advances in Urology·Manuela SchmidingerAlain Ravaud
Aug 30, 2013·Expert Opinion on Pharmacotherapy·Edwin M PosadasRobert A Figlin
May 25, 2016·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B CabarrouT Filleron
May 16, 2017·The Cochrane Database of Systematic Reviews·Susanne UnverzagtBarbara Seliger
Apr 15, 2015·Current Opinion in Supportive and Palliative Care·Paolo BossiAndrea Antonuzzo
Sep 8, 2018·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·David F McDermottMichael Atkins
Sep 26, 2020·Yonsei Medical Journal·Hee Jung Kang, Soohyeon Lee
Jul 20, 2018·Journal of Gynecologic Oncology·Michelle K WilsonMichael Friedlander
May 14, 2021·Clinical Genitourinary Cancer·Michael SzarekBernard J Escudier

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Software Mentioned

TWiST

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