TY - JOUR
T1 - Association of change in health-related quality of life and treatment discontinuation in metastatic breast cancer
T2 - a post hoc, exploratory analysis of two randomized clinical trials
AU - Kawahara, Takuya
AU - Iwamoto, Takayuki
AU - Takashima, Ikumi
AU - Hanazawa, Ryoichi
AU - Uemura, Kohei
AU - Uemura, Yukari
AU - Mukai, Hirofumi
AU - Kikawa, Yuichiro
AU - Taira, Naruto
N1 - Funding Information:
Dr. Mukai received honoraria from Pfizer, Takeda, Daiichi Sankyo, and Taiho, and research grant from Japanese government, Daiichi Sankyo, and Pfizer, outside the submitted work. Dr. Mukai is a member of the Board of Directors of Japan Breast Cancer Society. Dr. Kikawa has received honoraria from Eisai, Novartis, Pfizer, Lilly, Taiho, and Chugai, outside the submitted work.
Funding Information:
This study was sponsored by the Comprehensive Support Project for Oncology Research (CSPOR) of the Public Health Research Foundation. The research fund was provided to CSPOR by Taiho Pharmaceutical Company Limited under the study contract. Taiho Pharmaceutical took no part in this study other than providing information relevant to the proper use of the study drug.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/10
Y1 - 2022/10
N2 - Purpose: Identifying factors associated with treatment alteration (treatment discontinuation and dose reduction) may help to attain the treatment goals for metastatic breast cancer. The value of changes in the quality of life (QOL) in predicting treatment alteration remained unclear. This study aimed to examine the relationship between changes in the QOL and treatment alteration of first-line chemotherapy for metastatic breast cancer. Methods: We merged data from two randomized clinical trials in Japan, conducted from 2006 to 2017, that included patients who were diagnosed with human epidermal growth factor receptor 2-negative and endocrine treatment-resistant breast cancer, with metastatic disease at presentation or recurrence after surgery. The European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was used to assess QOL. The association between change in time-dependent QOL (worsening by 10-point or not) and time to treatment alteration was assessed using the Cox regression models controlling for patient characteristics (age, liver metastasis, hormone status, and treatment regimen) and baseline QOL. Results: Worsening physical functioning, global health status, and dyspnea were significantly associated with treatment discontinuation. Worsening role functioning, global health status, and fatigue were significantly associated with dose reduction. The threshold for defining worsening did not have a significant impact on the relationship. Conclusion: Changes in QOL are associated with the probability of treatment alteration among metastatic breast cancer patients. Physical functioning, role functioning, global health status, dyspnea, and fatigue should be prioritized for symptom management in patients with metastatic breast cancer.
AB - Purpose: Identifying factors associated with treatment alteration (treatment discontinuation and dose reduction) may help to attain the treatment goals for metastatic breast cancer. The value of changes in the quality of life (QOL) in predicting treatment alteration remained unclear. This study aimed to examine the relationship between changes in the QOL and treatment alteration of first-line chemotherapy for metastatic breast cancer. Methods: We merged data from two randomized clinical trials in Japan, conducted from 2006 to 2017, that included patients who were diagnosed with human epidermal growth factor receptor 2-negative and endocrine treatment-resistant breast cancer, with metastatic disease at presentation or recurrence after surgery. The European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was used to assess QOL. The association between change in time-dependent QOL (worsening by 10-point or not) and time to treatment alteration was assessed using the Cox regression models controlling for patient characteristics (age, liver metastasis, hormone status, and treatment regimen) and baseline QOL. Results: Worsening physical functioning, global health status, and dyspnea were significantly associated with treatment discontinuation. Worsening role functioning, global health status, and fatigue were significantly associated with dose reduction. The threshold for defining worsening did not have a significant impact on the relationship. Conclusion: Changes in QOL are associated with the probability of treatment alteration among metastatic breast cancer patients. Physical functioning, role functioning, global health status, dyspnea, and fatigue should be prioritized for symptom management in patients with metastatic breast cancer.
KW - Chemotherapy
KW - Dose reduction
KW - Metastatic breast cancer
KW - Quality of life
KW - Treatment discontinuation
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U2 - 10.1007/s00520-022-07283-0
DO - 10.1007/s00520-022-07283-0
M3 - Article
C2 - 35857127
AN - SCOPUS:85134495606
SN - 0941-4355
VL - 30
SP - 8367
EP - 8375
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 10
ER -
