Abstract
PurposeTo construct a model to predict preference-adjusted EuroQol 5D (EQ-5D) health utilities for patients with metastatic castrate-resistant prostate cancer (mCRPC) using the disease-specific health-related quality of life (HRQoL) measure, functional assessment of cancer therapy-prostate (FACT-P).MethodsHRQoL data were collected from patients with mCRPC who were enrolled in an observational study conducted in 47 centers across six European Union countries. Utility values were generated using a UK-specific EQ-5D value set. The predictive validity of the five FACT-P subscales, patient demographics, comorbidities and prior chemotherapy was tested using ordinary least squares (OLS), median, Gamma and Tobit multivariate regression models.ResultsFACT-P and EQ-5D questionnaires were completed by 602 (86 %) patients. Mean age [standard deviation (SD)] was 72.1 (7.9) years, mean time from diagnosis (SD) was 5.4 (4.4) years, and mean time since failure of androgen deprivation therapy (SD) was 1.0 (1.6) years. At study inclusion, 39 % of patients were chemotherapy-naïve, 37 % were undergoing chemotherapy, and 24 % were post-chemotherapy. Mean FACT-P and EQ-5D utility values were 104 and 0.66, respectively. OLS regression was the best-performing model, explaining 61.2 % of the observed EQ-5D variation. All FACT-P subscales were significantly predictive; the physical and functional well-being subscales had the highest explanatory value (coefficient 0.023 and 0.001, respectively, p < 0.0001). The other variables did not add additional explanatory value.ConclusionsThe algorithm developed enables translation of cancer-specific HRQoL measures to preference-adjusted health status in patients with mCRPC. The function may be useful in calculating EQ-5D scores when EQ-5D data have not been gathered directly.
Highlights
Prostate cancer is the most common cancer in Europe among men [1]
health-related quality of life (HRQoL) data were collected from patients with metastatic castrate-resistant prostate cancer (mCRPC) who were enrolled in an observational study conducted in 47 centers across six European Union countries
Patients were eligible for inclusion in the study if they had a histologically or cytologically confirmed diagnosis of adenocarcinoma of the prostate; prostate cancer progression documented by prostate-specific antigen according to Prostate Cancer Working Group 2 (PCWG2) criteria or radiographic progression, and disease progression despite surgical or medical castration [a testosterone level of \50 ng/dL (\1.735 nM) was required if testosterone levels were routinely measured]
Summary
Prostate cancer is the most common cancer in Europe among men [1]. In 2012, there were 417,000 new cases of prostate cancer in Europe, representing 12.1 % of all new cancers [1]. Despite 80–90 % of metastatic prostate cancer patients responding to androgen deprivation therapy [3], progression to castration-resistant disease occurs in most patients after. The health-related quality of life (HRQoL) of patients with prostate cancer declines substantially toward the end of life [5]. Treatment of metastatic castration-resistant prostate cancer (mCRPC) is mainly palliative, with the aim of prolonging survival, relieving symptoms and improving HRQoL. Bisphosphonates are prescribed for the management of metastatic bone disease (present in[90 % of patients with mCRPC [7]) to prevent skeletal-related events and improve symptom control [6]. Radionuclides, radiotherapy and analgesics may be considered for the management of bone pain [6]
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