PCN120 Quality of Life Among German Patients With Metastatic Castration-Resistant Prostate Cancer

Abstract

Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), a PRO instrument specifically designed to measure HRQoL of cancer patients. HRQoL was measured at screening, months 1, 3, 7, and at re-puncture. Meaningful deterioration was defined as a decrease in HRQoL scores of at least 5 points. Time to first meaningful deterioration was compared between catumaxomab (Nϭ160) and control (Nϭ85) groups using survival analysis techniques such as log-rank test and Cox models. RESULTS: Deterioration in HRQoL scores appeared more rapidly in the control group than the catumaxomab group (medians: 16-28 days vs. 45-49 days). The difference between the two groups in time to deterioration in HRQoL was statistically significant for all scores (pϽ0.01). Results were confirmed with Cox models (pϽ0.05). Hazard ratios ranged from 0.08 to 0.24. CONCLUSIONS: Treatment with catumaxomab delayed deterioration in HRQoL in patients with MA compared to paracentesis alone. The findings of this study indicate that the gain of puncture free survival due to catumaxomab treatment previously reported (Heiss et al. 2010) translates into a HRQoL benefit for the patients. OBJECTIVES:The majority of patients with prostate cancer progress to CRPC and frequently develop bone metastases. Treatment and management of bone metastases, as well as the underlying disease, influences the patient's quality of life. We evaluated the impact of bone metastases on utility (using EQ-5D) and quality of life (using FACT-P) in high-risk CRPC patients. METHODS: Data were extracted from the Adelphi Real World Prostate Cancer Disease-Specific Programme© (DSP), a cross-sectional survey of 348 urologists and oncologists and their prostate cancer patients that was conducted between and the UK. Physicians completed comprehensive record forms on 10 patients being actively treated for prostate cancer. Patients could also complete a questionnaire, which included the EQ-5D and FACT-P tools, however this was not compulsory. RESULTS: Of the 3,477 prostate cancer patients for which data were collected, 1,180 (34%) were categorised as having CRPC with a median time since diagnosis of 35.8 months. 146 patients with CRPC were identified as being at high risk for developing bone metastases (Gleason score Ն8, or a most recent PSA of Ն8ng/mL, or a PSA DT Յ10 months, or had received local therapy in addition to systemic medication). High-risk CRPC patients had an average EQ-5D index of 0.77 (nϭ36) and FACT-P of 99.54 (nϭ27). In contrast, patients with CRPC and bone metastases (nϭ680) had an average EQ-5D index of 0.59 (nϭ165) and FACT-P of 82.99 (nϭ147). Statistical differences were observed between the highrisk and bone metastases groups for both EQ-5D (pϭ0.0002) and FACT-P (pϭ0.0007). CONCLUSIONS: The development of bone metastases represents a significant additional burden for patients with CRPC highlighting the need for new treatments capable of preventing bone metastases in these patients.

Health-Related Quality of Life and Health Utilities in Metastatic Castrate-Resistant Prostate Cancer: A Survey Capturing Experiences from a Diverse Sample of UK Patients

“…Very little other information exists regarding the HRQOL of men with metastatic CRPC in the period of time before chemotherapy becomes clinically indicated (group 1) or is received (group 2). The EQ-5D utility values elicited in the present study are similar to EQ-5D utility values elicited from a German sample (0.81 before chemotherapy, 0.64 undergoing chemotherapy, 0.66 previously been treated with chemotherapy) [19]. Mean EQ-5D utility values from mixed country/treatment stage metastatic CRPC samples range from 0.59 (French, German, Italian, Spanish, and UK patients with/at high risk of developing bone metastases [13], mixed chemotherapy naive, current and prior chemotherapy New Zealand patients [15]) to 0.76 (mixed chemotherapy naive, current and prior chemotherapy German patients [15]).…”

“…Several studies are published only as non-peer reviewed conference abstracts, and information is lacking for patients with metastatic CRPC who have progressive disease in the period before chemotherapy becomes clinically indicated. Utility values for this subgroup have been reported in a German study [19], but this has not previously been investigated in a UK sample.…”

“…Cost-effectiveness decision analytic models for health technology assessment review in Australia, Canada, the United Kingdom, and a growing number of other countries require preference-weighted HRQOL data (utility values) to estimate quality-adjusted life-years. Although there is some published information on the HRQOL impact and health utility associated with CRPC [11][12][13][14][15][16][17][18][19], earlier studies have become out of date because of changes in the approach to treatment. Several studies are published only as non-peer reviewed conference abstracts, and information is lacking for patients with metastatic CRPC who have progressive disease in the period before chemotherapy becomes clinically indicated.…”

Quality of Life Improvement in Patients Treated with Degarelix versus Leuprorelin for Advanced Prostate Cancer

“…Therefore, the effect of PSA progression on HRQL was probably underestimated since the literature shows that HRQL decreases further with time. 2,5 Later in treatment utility can improve with successful therapy. Utilities as high as 0.81 were seen in patients still receiving cabazitaxel at 10 cycles vs 0.698 at baseline while utility during end of life care in the average patient is much lower at 0.5 to 0.6.…”

Health state utility values in breast and prostate cancer measured using EQ-5D: a systematic review of the literature

“…[15][16][17][18][19][20] A further study involving patients with CRPC reported that HRQoL was worse for patients with bone metastases than for patients without bone metastases (0.59 vs 0.77, respectively). 21 • An observational study investigating HRQoL according to stage of disease reported that utility values decreased from 0.87-0.90 for patients with localized disease to 0.74 for those with metastases and 0.59 for those receiving palliative care.…”