Abstract
BackgroundThis study evaluated the association between early tumor response at 8 weeks, previously reported as a positive outcome prognosticator, and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients enrolled in the ABSOLUTE trial.MethodsHRQOL was assessed using the EuroQol-5 Dimension (EQ-5D) utility index score in patients with complete response (CR) + partial response (PR) and progressive disease (PD) at 8 weeks, and time-to-deterioration (TtD) of the EQ-5D score, with the preset minimally important difference (MID) of 0.05, was compared between these populations. Among the enrolled patients, 143 and 160 patients were assessable in weekly solvent-based paclitaxel (Sb-PTX) arm and weekly nanoparticle albumin-bound paclitaxel (nab-PTX) arm, respectively.ResultsChanges of the EQ-5D score from baseline to 8 weeks in the nab-PTX arm were 0.0009 and − 0.1229 in CR + PR and PD patients, respectively; the corresponding values for the Sb-PTX arm were − 0.0019 and − 0.1549. For both treatments, changes of the EQ-5D score from baseline at 8 weeks were significantly larger in patients with PD than in those with CR + PR. The median TtD was 3.9 and 2.2 months in patients with CR + PR and PD, respectively, for nab-PTX [hazard ratio (HR) = 0.595, 95% confidence interval (CI) 0.358–0.989]. For Sb-PTX, the corresponding values were 4.7 and 2.0 months (HR = 0.494, 95% CI 0.291–0.841).ConclusionsEarly tumor shrinkage was associated with maintained HRQOL in AGC patients on the second-line chemotherapy with taxanes.
Highlights
Over 1,000,000 new cases of gastric cancer were reported worldwide in 2018
We focused on patients who had measurable lesions treated with weekly nanoparticle albumin-bound paclitaxel (nab-PTX) and SbPTX, and whose EuroQol-5 Dimension (EQ-5D) scores were available at baseline and at 8 weeks to assess the association between early tumor response and health-related quality of life (HRQOL)
The benefits of a new treatment or regimen can be evaluated based on improved overall survival (OS) and/or satisfactory HRQOL, which are metrics often used in clinical studies [24]
Summary
Over 1,000,000 new cases of gastric cancer were reported worldwide in 2018. Globally, gastric cancer is the fifth most common malignancy and the third leading cause of cancerrelated deaths [1]. This study evaluated the association between early tumor response at 8 weeks, previously reported as a positive outcome prognosticator, and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients enrolled in the ABSOLUTE trial. Results Changes of the EQ-5D score from baseline to 8 weeks in the nab-PTX arm were 0.0009 and − 0.1229 in CR + PR and PD patients, respectively; the corresponding values for the Sb-PTX arm were − 0.0019 and − 0.1549. For both treatments, changes of the EQ-5D score from baseline at 8 weeks were significantly larger in patients with PD than in those with CR + PR. Conclusions Early tumor shrinkage was associated with maintained HRQOL in AGC patients on the second-line chemotherapy with taxanes
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