Patient-reported pain severity, pain interference and health status in HR+/HER2− advanced/metastatic breast cancer

Wood, Robert; Mitra, Debanjali; Courcy, J. De; Iyer, Shrividya

doi:10.1136/esmoopen-2017-000227

Cited by 12 publications

(16 citation statements)

References 24 publications

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“…In our cohort, BPI "worst pain" was moderate/severe for 42% of patients, and "pain interference" was moderate/severe for 80% of patients. Increased pain severity has been associated with a worse HRQoL or health status in patients with advanced breast cancer [14,40,45]. However, patient-reported pain/discomfort was not an independent predictor of HRQoL in our regression analysis despite a high proportion (~70%) of the EU5 patients in our analysis reporting some/ extreme problems in the EQ-5D-3L domain of pain/discomfort.…”

Section: Discussioncontrasting

confidence: 56%

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Real-world patient-reported outcomes of women receiving initial endocrine-based therapy for HR+/HER2− advanced breast cancer in five European countries

et al. 2020

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Background Endocrine therapy (ET)-based regimens are the mainstay of treatment for patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) advanced breast cancer. With the introduction of new treatment classes, it is important to examine patient symptoms and health-related quality of life (HRQoL) at the start of this changing therapeutic landscape. This real-world study describes the patient-reported outcomes (PROs) of women with HR+/HER2− advanced breast cancer receiving ET-based regimens who were naïve to systemic treatment in the advanced setting across five European countries (EU5). Methods Data were collected between March and July 2017 from surveyed oncologists and their patients at a single time point using the multinational Adelphi Advanced Breast Cancer Disease Specific Programme™. Patients completed PRO questionnaires on HRQoL (EORTC QLQ-C30), pain severity and interference, and work and activity impairment. A multiple linear regression model explored factors associated with HRQoL. Results Across EU5, 226 physicians provided data on 781 women with HR+/HER2− advanced breast cancer taking their first ET-based regimen for advanced disease, of whom 252 provided PRO data. This subset had a mean age of 67.1 years, 94% were postmenopausal, 89% were diagnosed with advanced breast cancer at initial presentation, 79% had stage IV disease (66% of these patients had bone metastases and 38% had visceral metastases, including 18% with liver metastases) and 77% were on endocrine-only therapy as their initial treatment for advanced disease. The mean EORTC QLQ-C30 global health score (50.9) was worse than the reference value for patients with advanced breast cancer (60.2). Fatigue, pain, and insomnia were the most severe symptoms, and mean functioning scores were also worse than reference values. “Worst pain” and “pain interference” were moderate/severe for 42 and 80% of patients. Mean activity impairment was 44%, and greater activity impairment was associated with poorer HRQoL. Conclusions Despite receiving first-line ET-based regimens for advanced disease, these women had a poor HRQoL and high levels of symptoms, pain, pain interference and activity impairment. New treatments that maintain a stable disease state and reduce activity impairment may have a positive effect on the HRQoL of those living with advanced breast cancer.

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Section: Discussioncontrasting

confidence: 56%

“…PRO data on patients with advanced breast cancer in the real-world setting are limited, especially in those with HR+/HER2− disease [12][13][14][15][16][17]. Evidence is also lacking from European settings.…”

Section: Introductionmentioning

confidence: 99%

Real-world patient-reported outcomes of women receiving initial endocrine-based therapy for HR+/HER2− advanced breast cancer in five European countries

et al. 2020

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“…The primary study endpoint was to describe the health-utility score for the whole cohort. Previous studies on real-world QoL within breast cancer patients found several patient-, disease-, and treatment factors to exert a significant influence on the experienced QoL, including age [ 19 , 20 ], comorbidities [ 20 ], type of therapy [ 19 – 24 ], number of lines of therapy [ 21 , 24 ], location of metastases, [ 21 , 22 , 25 ], and disease progression [ 23 , 26 – 28 ]. Therefor, our secondary endpoints included differences in QoL between subgroups of patients based on age (≥ 65 versus < 65 years), comorbidity according to the Charlson index (yes versus no and multiple subdivisions in comorbidity), tumor subtype (hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status), current treatment type (endocrine, chemo- and/or targeted therapy), total number of prior palliative treatment lines, and number and metastatic site(s).…”

Section: Methodsmentioning

confidence: 99%

Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry

et al. 2020

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Purpose We aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL. Methods ABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods. Results A total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = − 0.106, p = 0.3136). Conclusion Within this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.

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“…For example, in a study of patients with painful metastatic bone cancer, moderate-to-severe pain interfered with the patients’ ability to walk, stand, and perform other activities. [47]…”

Section: Theoretical Framework: the Theory Of Unpleasant Symptomsmentioning

confidence: 99%

A Systematic Review: Mindfulness Intervention for Cancer-Related Pain

Ngamkham

Holden

Smith

2019

Asia-Pacific Journal of Oncology Nursing

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Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.

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Patient-reported pain severity, pain interference and health status in HR+/HER2− advanced/metastatic breast cancer

Cited by 12 publications

References 24 publications

Real-world patient-reported outcomes of women receiving initial endocrine-based therapy for HR+/HER2− advanced breast cancer in five European countries

Real-world patient-reported outcomes of women receiving initial endocrine-based therapy for HR+/HER2− advanced breast cancer in five European countries

Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry

A Systematic Review: Mindfulness Intervention for Cancer-Related Pain

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