Jenkins, V, Farewell, V, May, S, Catt, S, Matthews, L, Shilling, V, Dickson, J, Simcock, R and Fallowfield, L (2018) Do drugs offering only PFS maintain quality of life sufficiently from a patient’s perspective? Results from AVALPROFS (Assessing the ‘VALue’ to patients of PROgression Free Survival) study. Supportive Care in Cancer, 26 (11). pp. 3941-3949. ISSN 0941-4355
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Abstract
Purpose: Trials of novel drugs used in advanced disease often show only progression free survival or modest overall survival benefits. Hypothetical studies suggest that stabilisation of metastatic disease and/or symptom burden are worth treatment-related side-effects. We examined this premise contemporaneously using qualitative and quantitative methods.
Methods: Patients with metastatic cancers expected to live >6 months and prescribed drugs aimed at cancer control, were interviewed: - at baseline, 6 weeks, at progression and if treatment was stopped for toxicity. They also completed Functional Assessment of Cancer Therapy (FACT-G) plus Anti-Angiogenesis (AA) subscale questionnaires at baseline then monthly for 6 months.
Results: 90/120 (75%) eligible patients participated: 41 (45%) remained on study for 6 months, 36 progressed or died, 4 had treatment breaks and 9 withdrew due to toxicity. By 6 weeks, 66/69 (96%) patients were experiencing side-effects which impacted their activities. Low QoL scores at baseline did not predict a higher risk of death or drop out. At 6 week interviews, as the side effect severity increased, patients were significantly less inclined to view the benefit of cancer control as worthwhile (X2=50.7 P < 0.001). Emotional well-being initially improved from baseline by 10 weeks, then gradually returned to baseline levels.
Conclusion: Maintaining QoL is vital to most patients with advanced cancer so minimising treatment related side-effects is essential. As side-effect severity increased, drugs that controlled cancer for short periods were not viewed as worthwhile. Patients need to have the therapeutic aims of further anti-cancer treatment explained honestly and sensitively.
Item Type: | Article |
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Keywords: | Progression Free Survival;patients’ views;side-effects;quality of life |
Schools and Departments: | Brighton and Sussex Medical School > Sussex Health Outcomes Research & Education in Cancer (SHORE-C) |
Research Centres and Groups: | Sussex Health Outcomes Research and Education in Cancer |
Subjects: | R Medicine |
Depositing User: | Valerie Jenkins |
Date Deposited: | 17 May 2018 11:37 |
Last Modified: | 01 Jul 2019 13:01 |
URI: | http://sro.sussex.ac.uk/id/eprint/75907 |
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📧 Request an updateProject Name | Sussex Project Number | Funder | Funder Ref |
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AVALPROFS | Unset | Boehringer Ingelheim | Unset |