Abstract
The Functional Assessment of Cancer Therapy (FACT)–Antiangiogenesis (AntiA) Subscale was developed and validated to enhance treatment decision-making and side effect management for patients receiving anti-angiogenesis therapies. Side effects related to anti-angiogenesis therapies were identified from the literature, clinician input, and patient input. Fifty-nine possible patient expressions of side effects were generated. Patient and clinician ratings of the importance of these expressions led us to develop a 24-item questionnaire with clinical and research potential. To assess the scale's reliability and validity, 167 patients completed the AntiA Subscale, the Functional Assessment of Cancer Therapy-general (FACT-G), the FACT-Kidney Symptom Index (FKSI), the FACIT-Fatigue Subscale, the Global Rating of Change Scale (GRC), and the PROMIS Global Health Scale. Patient responses to the AntiA were analyzed for internal consistency, test–retest reliability, convergent and discriminant validity, and responsiveness to change in clinical status. All tested scales were found to have good internal consistency reliability (Cronbach's alpha 0.70–0.92). Test–retest reliability was also good (0.72–0.88) for total and subscale scores and lower for individual items. The total score, subscale scores, and all single items (except nosebleeds) significantly differentiated between groups defined by level of side effect bother. Evaluation of responsiveness to change in this study was not conclusive, suggesting an area for further research. The AntiA is a reliable and valid measure of side effects from anti-angiogenesis therapy.
Highlights
Unlike chemotherapy, which treats cancer by killing cells, angiogenesis inhibitors block tumor blood vessel development
Agents targeted to the mammalian target of rapamycin, which is associated with increased angiogenesis by binding to intracellular protein (FKBP12) [8], are associated with fatigue, rash, anemia, and metabolic abnormalities [9, 10]
Seventy-six of these articles were deemed relevant to patient side effects, symptoms, and health-related quality of life (HRQOL); side effects mentioned in the articles were cataloged
Summary
Unlike chemotherapy, which treats cancer by killing cells, angiogenesis inhibitors block tumor blood vessel development. Agents targeted to the mammalian target of rapamycin (mTOR), which is associated with increased angiogenesis by binding to intracellular protein (FKBP12) [8], are associated with fatigue, rash, anemia, and metabolic abnormalities [9, 10]. Because these drugs are often lifelong therapies, both immediate and long-term toxicities are important concerns in patient management [1, 2].
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