Abstract
Purpose
Uncertainty exists regarding Patient-Reported Outcomes (PROs) and Health-Related Quality of Life (HRQoL) of patients with metastatic colorectal cancer (mCRC) treated with cetuximab or bevacizumab. We conducted a prospective cohort study comparing PROs and HRQoL from both therapies.
Methods
We assessed PROs and HRQoL from patients treated with cetuximab or bevacizumab using QLQ-C30 and QLQ-CR29 questionnaires at three sequential time points, including baseline. Global Health Status (GHS), functional and symptom scales, and Overall Treatment Utility (derived from clinical and patient-reported outcomes) were compared for the two treatment strategies.
Results
Between January 2017 and April 2018, 44 patients were allocated to cetuximab (n = 19) or bevacizumab (n = 25). Except for RAS mutation status, patient baseline characteristics were generally well balanced across treatment groups. A higher proportion of patients experienced a deterioration in GHS (≥ 10%) in cetuximab arm − 53.8% (95% CI 25.1–80.8%) at 6 weeks and 66.7% (95% CI 29.9–92.5%) at 12 weeks—comparing to bevacizumab cohort: 18.2% (95% CI 5.2–40.3%) at 6 weeks and 12.5% (95% CI:1.6–38.3%) at 12 weeks. Treatment utility rates at 6 and 12 weeks were, respectively, 88.6% and 69.8% for bevacizumab, compared to 49% and 19.1% for cetuximab (p = 0.004), a difference confirmed in subset analyses.
Conclusions
In patients with mCRC, cetuximab-containing regimens led to a progressive negative impact on PROs and global HRQoL, when compared to baseline and bevacizumab. Future research is needed to confirm these results. Our findings demonstrate the value of PROs when assessing comparative effectiveness of different treatment regimens.
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RPM and APM conceived, designed, and planned the study. RPM led the study assessments and data acquisition process. HLP and AQ provided expertise on metastatic colorectal cancer and contributed to data acquisition. RPM interpreted and discussed the results. PH performed the statistical analysis, interpreted, and discussed the results. RPM and PH contributed to drafting of the manuscript. All authors read, provided feedback, and approved the final manuscript. All authors had full access to all of the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
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Marques, R.P., Heudtlass, P., Pais, H.L. et al. Patient-reported outcomes and health-related quality of life for cetuximab versus bevacizumab in metastatic colorectal cancer: a prospective cohort study. J Cancer Res Clin Oncol 145, 1719–1728 (2019). https://doi.org/10.1007/s00432-019-02924-0
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DOI: https://doi.org/10.1007/s00432-019-02924-0