Health-related quality of life in patients with metastatic colorectal cancer treated with panitumumab in first- or second-line treatment

Abstract

Background:Panitumumab in combination with chemotherapy was evaluated in two pivotal clinical trials in first- and second-line treatment of metastatic colorectal cancer (mCRC), respectively. This analysis compared the health-related quality of life (HRQoL) of patients with or without panitumumab in the two trials.Methods:Patients with mCRC were randomised to FOLFOX (first-line trial) or FOLFIRI (second-line trial)±panitumumab. The EuroQoL 5-Dimensions Health State Index (EQ-5D HSI) and Visual Analogue Scale (EQ-5D VAS) were assessed at baseline and monthly follow-up until disease progression. Patients with wild-type KRAS mCRC with baseline and post-baseline HRQoL scores were included. Difference in change from baseline between treatment groups was evaluated using linear mixed and pattern-mixture models.Results:In the first-line trial, 576 patients with wild-type KRAS mCRC (284 panitumumab+FOLFOX4 and 292 FOLFOX4 alone) were included in the HRQoL analyses. In the second-line trial, 530 patients with wild-type KRAS mCRC were included in these analyses (263 panitumumab+FOLFIRI and 267 FOLFIRI alone). There was no significant difference in the change in EQ-5D HSI and VAS scores between treatment groups in either trial.Conclusion:The addition of panitumumab to FOLFOX4 or FOLFIRI in first- or second-line treatment of wild-type KRAS mCRC significantly improved progression-free survival without compromising HRQoL.

Impact of tumour RAS/BRAF status in a first-line study of panitumumab + FOLFIRI in patients with metastatic colorectal cancer

“…Thus there is no evidence of an association between tumour KRAS/RAS status and toxicity. Furthermore, despite the high incidence of skin toxicity, generic quality of life (QoL) instruments have shown no impact of EGFR inhibitors plus FOLFIRI on overall QoL (Melosky et al , 2009; Bennett et al , 2011; Thaler et al , 2012). Although proactive management of skin toxicity may have reduced the impact for patients, it may also be that the QoL tools used in the study provided too general an assessment to determine the true impact of this AE.…”

Clinical Pharmacokinetics and Pharmacodynamics of the Epidermal Growth Factor Receptor Inhibitor Panitumumab in the Treatment of Colorectal Cancer

“…A higher response rate (RR) and longer PFS and OS were seen in patients who developed grade 2–4 skin toxicity versus patients with only grade 0–1 skin toxicity. Despite the large number of grade 3 or higher skin toxicity, panitumumab had no negative effect on overall quality of life (assessed using the EuroQol 5-domain health state index and overall health) [30, 31]. A quality-adjusted time without symptoms of disease or toxicity of treatment (Q-twist) was performed to provide an integrated measure of clinical benefit [32].…”

“…No premedication was required and very few infusion reactions (0.7%) and no fatal reactions were observed. Overall health status and health state index were measured using the EQ-5D scales [31]. Health-related quality of life did not differ between the treatment groups.…”

Improving Outcomes in Patients with CRC: The Role of Patient Reported Outcomes—An ESDO Report

“…However, analyses of the HRQoL assessments made during these studies showed no statistically significant or clinically meaningful overall differences in the change in HRQoL in patients treated with panitumumab–chemotherapy compared with those treated with chemotherapy alone [35]. …”