Hemoglobin levels and quality of life in patients with symptomatic chemotherapy-induced anemia: the eAQUA study

Abstract

PurposeTo assess hemoglobin (Hb) outcomes and fatigue-related quality-of-life (QoL) (electronic assessment) in patients with solid tumors and symptomatic chemotherapy-induced anemia receiving cytotoxic chemotherapy and darbepoetin alfa (DA) or another erythropoiesis-stimulating agent according to European indication.MethodseAQUA was a Phase IV prospective observational study. The primary outcome (assessed in the primary analysis set [PAS]: patients receiving one or more DA dose who had baseline and week 9 assessments for Hb and QoL) was the proportion of patients receiving DA having both Hb increases ≥1 g/dL and improved QoL between baseline and week 9. Functional Assessment of Cancer Therapy-Fatigue (FACT-F) subscale scores were anchored to fatigue visual analog scale scores to determine the minimally important difference for improved QoL. Overall data/data over time are reported for the full analysis set (patients receiving one or more erythropoiesis-stimulating agent dose, n=1,158); week 9 data (ie, data relating to the primary and secondary outcomes) are reported for the PAS (n=510). Baseline and safety data are included for both the full analysis set and PAS.ResultsIn the PAS, 69% of patients had stage IV disease and 96% were fatigued. The minimally important difference in FACT-F change score for QoL improvement was 3.5. From baseline to week 9, 32% (95% confidence interval: 28%–36%) of patients had both improved QoL and an Hb increase ≥1 g/dL; proportions were similar across the most common tumor types. At week 9, 49% and 58% of patients had improved QoL or Hb increases ≥1 g/dL, respectively; 70% and 76% had QoL or Hb improvements between baseline and study end, respectively. In the PAS, 16% of patients required transfusions and 32% required iron supplementation. Few patients (<1%) reported adverse drug reactions.ConclusionIn this study, patients with solid tumors receiving DA per European indication for symptomatic chemotherapy-induced anemia had clinically meaningful improvements in Hb and QoL.

Role of preoperative intravenous iron therapy to correct anemia before major surgery: a systematic review and meta-analysis

“…In our meta-analysis, although the Hb rise by 7.15 g/L is statistically significant, this rise is still considered below the defined clinical meaningful hemoglobin-concentration increase (≥1 g/dL) [ 74 ]. Interestingly, this modest Hb increase was associated with meaningful transfusion reduction.…”

Symptom burdens related to chemotherapy-induced anemia in stage IV cancer

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Distribution- and anchor-based methods to determine the minimally important difference on patient-reported outcome questionnaires in oncology: a structured review

“…(2011) [ 42 ] 2049 1564 Brief Pain Inventory-Short Form (BPI-SF) BPI-SF current pain and EQ-5D index score Mouysset, J.L. (2016) [ 43 ] 1262 510 FACT-F VAS of fatigue Ousmen, A. (2016) [ 62 ] 381 74 to 260 EORTC QLQ-C30; QLQ-BR23 Patient’s rating of change Pickard, A.S. (2007) [ 44 ] 534 534 EQ-5D Performance status Purcell, A.…”