When will I feel normal again? Quality of life trajectories after first-line chemotherapy for ovarian cancer.

172 Background: Patients often ask if/when they will feel normal again following treatment for ovarian cancer (OC). There is a paucity of data on the trajectories of quality of life (QoL), physical (PWB), social (SWB), emotional (EWB) and functional (FWB) wellbeing over time following chemotherapy and especially regarding those who have persistent problems. Our aim was to quantify the proportion of women with significantly lower QoL/wellbeing than the general population at the end of treatment and determine if/when they return to normal. Methods: The OPAL (Ovarian cancer Prognosis & Lifestyle) Study is a prospective study of Australian women diagnosed with invasive OC from 2012-15 who agreed to complete regular questionnaires after diagnosis. 580 participants who received ≥3 cycles of platinum-based chemotherapy as primary treatment and completed a questionnaire while on or < 6 weeks after completing chemotherapy (baseline) were included. FACT-G data came from questionnaires at baseline and ~3, 6, 9 & 18 months post-baseline. Group-based trajectory models were used to identify groups with distinct patterns of QoL/wellbeing over time. Results: Overall, 44% (254) of women had QoL scores significantly lower than the general population at baseline; 35% (88) returned to normal by 3 months after treatment, 73% by 6 months and 27% (69) had not returned to normal by 18 months. The Table shows the comparable figures for the wellbeing subscales. Conclusions: While > 50% of women with OC can expect similar QoL, FWB and EWB to the general population at the end of chemotherapy, PWB was compromised in 3 of 4 women. For most, wellbeing recovered within 6 months but a substantial proportion reported ongoing deficits. A particularly prolonged impact was seen for those with poor EWB at baseline, warranting early intervention in this subset. [Table: see text]

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DICE: Study Protocol for a Randomised Trial Investigating a Novel Therapy Called TAK228 in Ovarian Cancer Resistant to Standard Treatment

10.21203/rs.3.rs-572444/v1 ◽

2021 ◽

Author(s):

Lee Webber ◽

Francesca Fiorentino ◽

Jonathan Krell ◽

Consuelo Nohpal de la Rosa

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Adverse Events ◽

Standard Treatment ◽

Phase Iii ◽

Response To Treatment ◽

Weekly Paclitaxel ◽

Novel Therapy ◽

Platinum Based Chemotherapy

Abstract Background:The standard initial treatment for ovarian cancer is surgery and platinum-based chemotherapy and potentially maintenance therapy with avastin or inhibitors of poly-ADP ribose polymerase (PARP). While a proportion of women are cured by this approach, the vast majority will relapse and become resistant to platinum chemotherapy either initially or on subsequent treatment. There is an unmet need to improve response to treatment and quality of life in these women. TAK228 is a novel therapy that can be added to standard treatment in the participant population and the aim of the DICE trial is to assess its effectiveness. Laboratory and clinical research has shown that these ovarian cancers may respond to the molecular target of a drug such as TAK228, and there have been studies using it in other advanced solid tumours including endometrial cancer. Methods: 124 eligible women will be recruited from participating research sites in the United Kingdom (UK) and Germany. Randomised participants will receive either weekly paclitaxel alone (standard treatment, n=62) or TAK228 plus weekly paclitaxel (n=62) until the cancer significantly worsens, there are significant adverse events or any other protocol-defined stopping criteria. Participants will be monitored for response to treatment (using radiological imaging), adverse events and quality of life during both randomised treatment and subsequent follow up.Discussion:The primary objective/endpoint of the study is to compare the two treatments in terms of progression free survival, or the length of time that each participant is alive without the cancer significantly worsening according to defined assessment criteria. If the addition of TAK228 to weekly paclitaxel chemotherapy is shown to significantly improve this statistically, and adverse events and quality of life are not significantly worse than standard treatment, then TAK228 plus weekly paclitaxel could potentially be taken forward within the context of a larger phase III trial.Trial registration:ClinicalTrials.gov NCT03648489. Registered 27th August 2018.https://clinicaltrials.gov/ct2/show/NCT03648489

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Weekly platinum-based chemotherapy versus 3-weekly platinum-based chemotherapy for newly diagnosed ovarian cancer (ICON8): quality-of-life results of a phase 3, randomised, controlled trial

The Lancet Oncology ◽

10.1016/s1470-2045(20)30218-7 ◽

2020 ◽

Vol 21 (7) ◽

pp. 969-977 ◽

Cited By ~ 1

Author(s):

Sarah P Blagden ◽

Adrian D Cook ◽

Christopher Poole ◽

Lesley Howells ◽

Ian A McNeish ◽

...

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Newly Diagnosed ◽

Phase 3 ◽

Platinum Based Chemotherapy ◽

Randomised Controlled

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1466Vitamin D status before, during and after treatment and ovarian cancer survival

International Journal of Epidemiology ◽

10.1093/ije/dyab168.571 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Tanya Ross ◽

Penny Webb ◽

Rachel Neale

Keyword(s):

Ovarian Cancer ◽

Vitamin D ◽

Survival Data ◽

Cancer Survival ◽

Cox Regression ◽

Primary Treatment ◽

Parametric Models ◽

Cancer Prognosis ◽

Ovarian Cancer Survival ◽

Ovarian Cancer Prognosis

Abstract Background Previous work found higher serum 25-hydroxyvitamin D (25(OH)D) [circulating form of vitamin D] concentrations at diagnosis were associated with longer survival in patients with ovarian cancer (OvCa). There was no evidence for an association with 25(OH)D after primary treatment, but power was limited. Our aim was to reassess this association in a larger sample, including measures collected during treatment and using techniques to deseasonalise 25(OH)D. Methods Participants were diagnosed between 2002-2006 and 2012-2015 from the Australian Ovarian Cancer Study (AOCS) and the Ovarian Cancer, Prognosis and Lifestyle (OPAL) study, respectively. 25(OH)D concentrations were available for 676 at diagnosis (AOCS), 805 during treatment (AOCS:208; OPAL:597) and 861 after completion of primary treatment and before recurrence (AOCS:342; OPAL:519); 1006 AOCS samples were included in the previous analysis. Sociodemographic, diet and lifestyle data came from questionnaires self-completed at recruitment, and clinical/survival data from medical records, supplemented with National Death Index linkage. We will use Cox regression and non-parametric models to examine associations with survival. Results Median 25(OH)D concentrations were lowest during treatment, intermediate at diagnosis and highest after treatment (AOCS 51, 64, and 71 nmol/L, respectively). 5-year survival was 50% in AOCS and 59% in OPAL. Updated survival results will be presented. Conclusions If the association is confirmed in this updated analysis, then increasing vitamin D concentrations may provide a way to improve survival following OvCa. Key messages Higher circulating vitamin D concentrations may improve survival in OvCa.

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Quality of Life Trajectories of Older Adults Living in Senior Housing

Research on Aging ◽

10.1177/0164027517713313 ◽

2017 ◽

Vol 40 (6) ◽

pp. 511-534 ◽

Cited By ~ 7

Author(s):

Amy Restorick Roberts ◽

Kathryn Betts Adams

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Social Engagement ◽

Leisure Activities ◽

Panel Study ◽

Senior Housing ◽

Life Trajectories ◽

The Face ◽

Over Time

Quality of life (QoL) in the face of declining health, mobility, and social losses is a central issue for older adults. Our study examined changes in QoL over time for older adults residing in independent senior housing within continuing care retirement communities (CCRCs) and estimated how residents’ social engagement during their first year influenced QoL over the next 4 years. Data were drawn from a 5-year panel study of 267 older adults who moved into senior housing within four CCRCs. Although initial QoL varied between individuals, QoL declined for the group over time. One component of early social engagement—participating in a greater number of formal social activities organized by the CCRC—significantly slowed the rate of decline in QoL. Findings suggest that senior housing residents may benefit from early participation in organized social and leisure activities soon after move-in to forestall declines in QoL over the long term.

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Quality-of-Life Trajectories at the End of Life: Assessments over Time by Patients with and without Cancer

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2010.02734.x ◽

2010 ◽

Vol 58 (3) ◽

pp. 472-479 ◽

Cited By ~ 14

Author(s):

Lois Downey ◽

Ruth A. Engelberg

Keyword(s):

Quality Of Life ◽

End Of Life ◽

Life Trajectories ◽

Over Time

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Quality of Life in Ovarian Cancer: A Threat to Women Health in Pakistan

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4663 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 3170-3175

Author(s):

Madeeha Malik ◽

Emmama Jamil ◽

Azhar Hussain

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Univariate Analysis ◽

Sampling Technique ◽

Primary Treatment ◽

Cross Sectional ◽

Term Care ◽

Validated Questionnaire ◽

Significant Difference

Quality of life evaluation is a valuable measure in optimizing care of patients with ovarian cancer, but more research is required to make such evaluations suitably inexpensive and easy to perform so that they can be more fully incorporated into general oncologic practice. The present study was designed to assess the quality of life among ovarian cancer patients in Pakistan. A descriptive cross-sectional study design was used. A pre validated questionnaire, i.e. EORTC-QLQ-Ov-28 was self-administered to a sample of 383 women diagnosed with ovarian cancer selected using a convenience sampling technique. After data collection, data was cleaned, coded and entered in SPSS. Univariate analysis was performed to find out the differences among different variables. Univariate analysis was conducted comparing the symptom and functioning scales with clinical factors such as age, obesity, setting, hormonal issue, family history, and marital status. The results of the current study highlighted a significant difference (p ≥ 0.05) in the quality of life of women with respect to all of the indicators. The results of the present study concluded poor quality of life among women with ovarian cancer in Pakistan. The lowest quality of life score was observed in hormonal problems followed by peripheral neuropathy, whereas the attitude to disease or treatment was found positive. Cancer care should be extended beyond primary treatment to include long-term care that addresses physical, psychosocial, and emotional factors that influence survivor’s quality of life throughout their lifetime.

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Effect of genetic testing results on patient-reported quality of life among patients undergoing panel testing for newly diagnosed ovarian cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.1584 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 1584-1584

Author(s):

Sarah S. Lee ◽

Melissa Kristen Frey ◽

Deanna Gerber ◽

Zachary Phillip Schwartz ◽

Jessica Martineau ◽

...

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Genetic Testing ◽

Anxiety And Depression ◽

Newly Diagnosed ◽

Pathogenic Mutations ◽

Patient Reported ◽

Clinically Significant ◽

Over Time

1584 Background: This study compared patient-reported stress, anxiety, and depression between newly diagnosed ovarian cancer patients with pathogenic genetic testing results versus patients with non-informative results (i.e., variants of uncertain significance (VUS) or negative). Methods: Patients underwent genetic testing (GT) via a facilitated referral pathway (Frey et al, Gynecol Oncol 2020) through which they were referred for genetic counseling and GT by their gynecologic oncologist within six weeks of diagnosis from 10/2015 to 5/2019. English-speaking patients completed three quality of life (QoL) instruments: Impact of Events Scale (IOES), State-Trait Anxiety Questionnaire (STAI), Hospital Anxiety and Depression Scale (HADS) immediately pre-and post-GT and 6 months post GT. Two-way mixed ANOVA was performed to analyze effect of GT results on QoL over time with significance p < 0.05. Results: One hundred ten patients were enrolled in the pathway and 83 (76%) patients underwent GT. Among these, 15 (18%) had potentially actionable pathogenic mutations ( BRCA1-8, BRCA2-4, MSH2-2, MRE11A-1); 26 (31%) had VUS results; 3 (4%) had both a pathogenic mutation and a VUS result; and 42 (51%) had negative results. Sixty patients (72%) completed QoL assessments pre and post GT, and 37 (44%) patients at 6-9 months post GT. For all patients, GT results did not affect QoL scales across our time points. By mean scores across all-comers, patients demonstrated mild stress at each time point and clinically significant anxiety immediate post-GT. All patients had a statistically significance decrease in HADS depression scores over time from pre-GT to 6 months post-GT (mean score 4.98 vs 2.97, p = 0.020). Patients with VUS had lower HADS mean anxiety scores across time (3.62) compared to patients with pathogenic (7.44) or negative mutations (6.83, p = 0.029). For patients without mutations, there was a significant decrease in clinically significant anxiety by STAI-state score at 6 months (p = 0.002) and a decrease in borderline anxiety by HADS scores at 6 months (p = 0.005). This effect was not present for patients with pathogenic mutations or VUS. Conclusions: A pathogenic result does not impact QoL scales immediately pre or post GT or at 6 months post GT, though patients with negative mutations were more likely to show a decrease in anxiety over time. Patients should be recommended GT at time of diagnosis of ovarian cancer without concern of increased stress, anxiety, or depression based on GT results.

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Financial toxicity and patient-reported outcomes over time: A longitudinal study of women with recurrent ovarian cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.6079 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 6079-6079

Author(s):

Larissa Meyer ◽

Amy Schneider ◽

Tsun Hsuan Chen ◽

Xin Shelley Wang ◽

Charlotte C. Sun

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Longitudinal Study ◽

Multivariable Analysis ◽

Financial Toxicity ◽

Patient Reported ◽

Baseline Cost ◽

Over Time ◽

Screening Measures

6079 Background: The chronic nature of treatment for ovarian cancer (OC) can place women at increased risk of financial toxicity (FT) from ongoing direct and indirect costs coupled with potential loss of income. We explored FT and its association with anxiety, depression, and quality of life over time in women with recurrent OC. Methods: Women with recurrent OC enrolled in a longitudinal study were given the following validated instruments at baseline and every 3 months: FACIT Comprehensive Score for Financial Toxicity (COST), GAD-7 (anxiety), CES-D (depression) and FACT-Ovary. Mixed models were performed on longitudinal data over 12 months of follow-up. Multivariable analysis of demographic data was performed. Results: 225 patients were divided into low FT (top 2 terciles, n = 152) and high FT (bottom tercile, n = 73,) by baseline COST scores. The median age was 59 (range 22.9-78.9). There were no significant differences between the groups in regards to marital status, number of people in household or education level. There were significant differences between the low and high financial toxicity groups in terms of median age (low FT = 61 yrs vs. high FT = 54 yrs, p < 0.0001); race (5.4% black in low FT vs. 15.1% in high FT, p = 0.04), number of children < 18 years in the home ((p = 0.02), employment status p( < 0.0001) and annual income p( < 0.0001). On multivariable analysis, only income and age remained significantly associated with FT. The mean baseline COST score in the low FT group was 34 vs. 16 in the high FT group. Interestingly, pts with low baseline FT had significant worsening of FT over the 12 month time period while those with high FT had slight improvement over time. Consistently, the high FT group had higher scores on screening measures for anxiety and depression, as well as lower overall quality of life which persisted over time. Conclusions: Financial toxicity is a measurable and clinically relevant patient reported outcome. The cohort of women with high FT demonstrated higher mean scores on screening measures for depression and anxiety as well as persistently lower quality of life. Targeted interventions to decrease financial toxicity may provide more global improvements in mental health and quality of life.

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