QUALITY OF LIFE FOR PATIENTS WITH METASTATIC BREAST CANCER TREATED BY DOXORUBICIN AND PACLITAXEL

Side Effects ◽

Metastatic Breast ◽

Emotional Function ◽

Global Quality ◽

Global Quality Of Life ◽

Eortc Qlq

Background: Metastatic breast cancer is still remains essentially incurable. Palliative chemotherapy with the combination of Doxorubicin and Paclitaxel is to reduce the burden of disease, prolong overall survival and maintain quality of life for patients. The objectives of this study to evaluate the clinical effectiveness of this regimen for patients with metastatic breast cancer and the impact on the quality of life of patients. Patients and methods: Included 26 patients with metastatic breast cancer treated by Doxorubicin and Paclitaxel at the Hue University Hospital from 2010 to 1014. Patient characteristics and response rates were recorded. Quality of life questionnaires was assessed with the EORTC QLQ-C30 for general cancer patients and EORTC QLQ-BR23 for breast cancer. Results: Clinical response was achieved in 14 patients (53.8%), including 11.5% complete response, 43.4% partial remission and stable disease is 34.6%. The number of patients with response and stable disease are for at least 4 months prior to progression. Quality of life changes significantly statistical including: physical function decreased slightly (mean change 7.6 points) after 4 cycles of chemotherapy, cognitive function decreased slightly after the 8th cycle (8.1 points). Emotional function improved partially (7.7 points). However, the global quality of life has not changed. Changes in body image can adversely affect patients with a decrease of 15.9 points. These symptoms have been reported in breast including pain, swelling and discomfort with little difference of 2.9 points. The side effects of chemotherapy in organs such as the reduction or loss of appetite, headache, menstrual disorders vary in significance with an increase of 18.8 points. Distress associated with hair loss also increased significantly with 75.5 points. Conclusion: Paclitaxel and doxorubicin for patients with metastatic breast cancer showed significant clinical improvement and well-tolerated toxicity. Emotional function have been improved. Some aspects slightly decreased such as physical, cognitive, and distress of body image changes, side effects of chemotherapy and hair loss. However, global quality of life of was maintained. Although sample in this study was still small but routinely assess the quality of life for patients with metastatic breast cancer receiving chemotherapy should be routinely recommended.

Quality of Life in a Randomized Trial of Group Psychosocial Support in Metastatic Breast Cancer: Overall Effects of the Intervention and an Exploration of Missing Data

10.1200/jco.2003.04.080 ◽

2003 ◽

Vol 21 (10) ◽

pp. 1944-1951 ◽

Cited By ~ 89

Author(s):

Louise Bordeleau ◽

John Paul Szalai ◽

Marguerite Ennis ◽

Molyn Leszcz ◽

Michael Speca ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Missing Data ◽

Metastatic Breast ◽

Life Questionnaire ◽

European Organization ◽

Eortc Qlq C30 ◽

Eortc Qlq

Purpose: To evaluate the effect of a standardized group psychosocial intervention on health-related quality of life (HrQOL) in women with metastatic breast cancer and to explore the effect of missing data in HrQOL analyses. Patients and Methods: Between 1993 and 1998, seven Canadian centers randomly assigned 235 eligible women to participate in a weekly, 90-minute, therapist-led support group that adhered to principles of supportive-expressive (SE) therapy or to a control arm (no SE). All women received educational material and any type of medical or psychosocial care deemed necessary. HrQOL data were prospectively collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) at baseline, 4, 8, and 12 months. The primary HrQOL analyses compared scores in the two study arms. Analyses were limited to women with appropriate baseline HrQOL information (n = 215). Results: Baseline EORTC QLQ-C30 scores were not different between the two study arms (all P > .05). Primary analysis of all subscales failed to show a significant influence of the intervention on HrQOL (all P > .05). There was a significant deterioration over time in several functional scales of the EORTC QLQ-C30: global (P = .03), physical (P = .0002), role (P = .01), and cognitive functioning (P = .04); and in symptom scales: dyspnea (P = .007), appetite loss (P = .04), and fatigue (P = .003); these changes were independent of randomization allocation. Results were similar in additional analyses of overall HrQOL using a variety of approaches to handling missing data. Conclusion: Supportive-expressive group therapy in patients with metastatic breast cancer does not appear to influence HrQOL, as measured by the EORTC QLQ-C30.

Phase III Trial of Doxorubicin, Paclitaxel, and the Combination of Doxorubicin and Paclitaxel as Front-Line Chemotherapy for Metastatic Breast Cancer: An Intergroup Trial (E1193)

10.1200/jco.2003.08.013 ◽

2003 ◽

Vol 21 (4) ◽

pp. 588-592 ◽

Cited By ~ 510

Author(s):

George W. Sledge ◽

Donna Neuberg ◽

Patricia Bernardo ◽

James N. Ingle ◽

Silvana Martino ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Single Agent ◽

Metastatic Breast ◽

Complete Response ◽

Phase Iii ◽

Global Quality Of Life ◽

Intergroup Trial

Purpose: Between February 1993 and September 1995, 739 patients with metastatic breast cancer were entered on an Intergroup trial (E1193) comparing doxorubicin (60 mg/m2), paclitaxel (175 mg/m2/24 h), and the combination of doxorubicin and paclitaxel (AT, 50 mg/m2 and 150 mg/m2/24 h, plus granulocyte colony-stimulating factor 5 mg/kg) as first-line therapy. Patients receiving single-agent doxorubicin or paclitaxel were crossed over to the other agent at time of progression. Patients and Methods: Patients were well balanced for on-study characteristics. Results: Responses (complete response and partial response) were seen in 36% of doxorubicin, 34% of paclitaxel, and 47% of AT patients (P = .84 for doxorubicin v paclitaxel, P = .007 for v AT, P = .004 for paclitaxel v AT). Median time to treatment failure (TTF) is 5.8, 6.0, and 8.0 months for doxorubicin, paclitaxel, and AT, respectively (P = .68 for doxorubicin v paclitaxel, P = .003 for doxorubicin v AT, P = .009 for paclitaxel v AT). Median survivals are 18.9 months for patients taking doxorubicin, 22.2 months for patients taking paclitaxel, and 22.0 months for patients taking AT (P = not significant). Responses were seen in 20% of patients crossing from doxorubicin → paclitaxel and 22% of patients crossing from paclitaxel → doxorubicin (P = not significant). Changes in global quality-of-life measurements from on-study to week 16 were similar in all three groups. Conclusion: (1) doxorubicin and paclitaxel, in the doses used here, have equivalent activity; (2) the combination of AT results in superior overall response rates and time to TTF; and (3) despite these results, combination therapy with AT did not improve either survival or quality of life compared to sequential single-agent therapy.

Effects on Quality of Life of Combined Trastuzumab and Chemotherapy in Women With Metastatic Breast Cancer

10.1200/jco.2002.03.090 ◽

2002 ◽

Vol 20 (14) ◽

pp. 3106-3113 ◽

Cited By ~ 93

Author(s):

David Osoba ◽

Dennis J. Slamon ◽

Michael Burchmore ◽

Maureen Murphy

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Combined Therapy ◽

Metastatic Breast ◽

Care Quality ◽

Life Questionnaire ◽

European Organization ◽

Global Quality Of Life

PURPOSE: The study was designed to compare the effects of treatment with a combination of trastuzumab (Herceptin; Genentech, Inc, South San Francisco, CA) and chemotherapy versus chemotherapy alone on health-related quality of life (HRQL) in patients with HER-2/neu overexpressing, metastatic breast cancer. PATIENTS AND METHODS: A sample of 400 patients, not previously treated for metastatic disease and randomized to receive either trastuzumab plus chemotherapy (208 patients) or chemotherapy alone (192 patients), completed the European Organization for Research and Treatment Care Quality of Life Questionnaire at baseline and on at least one subsequent occasion at 8, 20, 32, 44, and 56 weeks. HRQL improvement or worsening was defined as a ≥ 10-point change (range, 0 to 100 points) in the scores of six preselected domains (global quality of life [QOL], physical, role, social, and emotional functioning, and fatigue). Stable HRQL was defined as a change of less than 10. A Bonferroni correction was applied for multiple testing. RESULTS: After completion of chemotherapy, patients treated with trastuzumab and chemotherapy reported significant improvement in fatigue (P < .05) as compared with their baseline scores. Higher proportions of patients receiving the combined therapy achieved improvement in global QOL (P < .05) than did patients treated with chemotherapy alone. Higher proportions of the combined therapy group also achieved improvement in physical and role functioning and in fatigue as compared with the chemotherapy group, but the differences were not statistically significant. There were no differences in the proportions of patients in the two groups that reported worsening. CONCLUSION: Statistically significantly higher proportions of patients treated with a combination of trastuzumab and chemotherapy reported improved global QOL than did patients treated by chemotherapy alone.

Measuring the Time to Deterioration for Health-Related Quality of Life in Patients With Metastatic Breast Cancer Using a Web-Based Monitoring Application: Longitudinal Cohort Study (Preprint)

10.2196/preprints.25776 ◽

2020 ◽

Author(s):

Katharina Brusniak ◽

Manuel Feisst ◽

Linda Sebesteny ◽

Andreas Hartkopf ◽

Joachim Graf ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cox Regression ◽

Metastatic Breast ◽

Related Quality ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Eq Vas

BACKGROUND Health-related quality of life (HRQoL) is used to evaluate the treatment of metastatic breast cancer. In a long-term therapy setting, HRQoL can be used as an important benchmark for treatment success. With the help of digital apps, HRQoL monitoring can be extended to more remote areas and be administered on a more frequent basis. OBJECTIVE This study aims to evaluate 3 common HRQoL questionnaires in metastasized breast cancer in terms of TTD in a digital, web-based setting. We further aim to examine the development of the HRQoL in different systemic treatment groups in each of these evaluation instruments. METHODS A total of 192 patients with metastatic breast cancer were analyzed in this bicentric prospective online cohort study at two German university hospitals. Patients completed questionnaires on HRQoL (EuroQol Visual Analog Scale [EQ-VAS], EuroQol 5 Dimension 5 Level [EQ-5D-5L], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 item [EORTC QLQ-C30]) via an online platform over a 6-month period. Treatment schedules and medical history were retrieved from medical records. Unadjusted Cox regression analysis on treatment-related factors was performed. We conducted subgroup analyses in regard to TTD events between different treatments. RESULTS The EQ-VAS showed a higher rate of deterioration after 8 weeks (84/179, 46.9%) than the EQ-5D-5L (47/163, 28.8%) and EORTC QLQ-C30 (65/176, 36.9%). Unadjusted Cox regression revealed significant connections between known metastases in the liver (<i>P</i>=.03, HR 1.64, 95% CI 1.06-2.52) and pleura (<i>P</i>=.04, HR 0.42, 95% CI 0.18-0.96) in the EQ-VAS. Significant relations between EQ-VAS events and single EQ-5D-5L items and the EQ-5D-5L summary score were demonstrated. All treatment groups significantly differed from the CDK4/6 inhibition subgroup in the EQ-VAS. CONCLUSIONS Compared to the EQ-5D-5L and QLQ-C30, the EQ-VAS showed a higher rate of deterioration after 8 weeks. Significant connections to certain metastatic locations were only detected in the EQ-VAS. The EQ-VAS is capable of reflecting the distinctive HRQoL profiles of different systemic treatments as well as the different aspects of HRQoL presented in the EQ-5D-5L. TTD with the EQ-VAS is an adequate mean of examining longitudinal development of HRQoL among breast cancer patients.

Measuring the Time to Deterioration for Health-Related Quality of Life in Patients With Metastatic Breast Cancer Using a Web-Based Monitoring Application: Longitudinal Cohort Study

JMIR Cancer ◽

10.2196/25776 ◽

2021 ◽

Vol 7 (4) ◽

pp. e25776

Author(s):

Katharina Brusniak ◽

Manuel Feisst ◽

Linda Sebesteny ◽

Andreas Hartkopf ◽

Joachim Graf ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cox Regression ◽

Metastatic Breast ◽

Related Quality ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Eq Vas

Background Health-related quality of life (HRQoL) is used to evaluate the treatment of metastatic breast cancer. In a long-term therapy setting, HRQoL can be used as an important benchmark for treatment success. With the help of digital apps, HRQoL monitoring can be extended to more remote areas and be administered on a more frequent basis. Objective This study aims to evaluate 3 common HRQoL questionnaires in metastasized breast cancer in terms of TTD in a digital, web-based setting. We further aim to examine the development of the HRQoL in different systemic treatment groups in each of these evaluation instruments. Methods A total of 192 patients with metastatic breast cancer were analyzed in this bicentric prospective online cohort study at two German university hospitals. Patients completed questionnaires on HRQoL (EuroQol Visual Analog Scale [EQ-VAS], EuroQol 5 Dimension 5 Level [EQ-5D-5L], European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 item [EORTC QLQ-C30]) via an online platform over a 6-month period. Treatment schedules and medical history were retrieved from medical records. Unadjusted Cox regression analysis on treatment-related factors was performed. We conducted subgroup analyses in regard to TTD events between different treatments. Results The EQ-VAS showed a higher rate of deterioration after 8 weeks (84/179, 46.9%) than the EQ-5D-5L (47/163, 28.8%) and EORTC QLQ-C30 (65/176, 36.9%). Unadjusted Cox regression revealed significant connections between known metastases in the liver (P=.03, HR 1.64, 95% CI 1.06-2.52) and pleura (P=.04, HR 0.42, 95% CI 0.18-0.96) in the EQ-VAS. Significant relations between EQ-VAS events and single EQ-5D-5L items and the EQ-5D-5L summary score were demonstrated. All treatment groups significantly differed from the CDK4/6 inhibition subgroup in the EQ-VAS. Conclusions Compared to the EQ-5D-5L and QLQ-C30, the EQ-VAS showed a higher rate of deterioration after 8 weeks. Significant connections to certain metastatic locations were only detected in the EQ-VAS. The EQ-VAS is capable of reflecting the distinctive HRQoL profiles of different systemic treatments as well as the different aspects of HRQoL presented in the EQ-5D-5L. TTD with the EQ-VAS is an adequate mean of examining longitudinal development of HRQoL among breast cancer patients.

Randomized Phase III Study of Docetaxel Compared With Paclitaxel in Metastatic Breast Cancer

10.1200/jco.2005.02.027 ◽

2005 ◽

Vol 23 (24) ◽

pp. 5542-5551 ◽

Cited By ~ 346

Author(s):

S.E. Jones ◽

J. Erban ◽

B. Overmoyer ◽

G.T. Budd ◽

L. Hutchins ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Metastatic Breast ◽

Phase Iii ◽

Open Label ◽

Global Quality ◽

Global Quality Of Life ◽

Phase Iii Study ◽

Over Time

PurposeThis randomized, controlled, multicenter, open-label, phase III study compared docetaxel versus paclitaxel in patients with advanced breast cancer that had progressed after an anthracycline-containing chemotherapy regimen.Patients and MethodsPatients (n = 449) were randomly assigned to receive either docetaxel 100 mg/m2(n = 225) or paclitaxel 175 mg/m2(n = 224) on day 1, every 21 days until tumor progression, unacceptable toxicity, or withdrawal of consent.ResultsIn the intent-to-treat population, both the median overall survival (OS, 15.4 v 12.7 months; hazard ratio [HR], 1.41; 95% CI, 1.15 to 1.73; P = .03) and the median time to progression (TTP, 5.7 months v 3.6 months; HR, 1.64; 95% CI, 1.33 to 2.02; P < .0001) for docetaxel were significantly longer than for paclitaxel, and the overall response rate (ORR, 32% v 25%; P = .10) was higher for docetaxel. These results were confirmed by multivariate analyses. The incidence of treatment-related hematologic and nonhematologic toxicities was greater for docetaxel than for paclitaxel; however, quality-of-life scores were not statistically different between treatment groups over time.ConclusionDocetaxel was superior to paclitaxel in terms of OS and TTP. ORR was higher for docetaxel. Hematologic and nonhematologic toxicities occurred more frequently in the docetaxel group. The global quality-of-life scores were similar for both agents over time.

Treatment-related side effects and views about dosage assessment to sustain quality of life: Results of an advocate-led survey of patients with metastatic breast cancer (MBC).

10.1200/jco.2021.39.15_suppl.1005 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 1005-1005

Author(s):

Anne L Loeser ◽

Jeffrey M. Peppercorn ◽

Mark E. Burkard ◽

Kevin Kalinsky ◽

Hope S. Rugo ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Side Effects ◽

Side Effect ◽

Dosage Reduction ◽

Metastatic Breast ◽

Significant Treatment ◽

New Treatment

1005 Background: Metastatic breast cancer (MBC) is generally incurable and the majority of patients with MBC will remain on treatment indefinitely. Patients usually begin each new treatment at the Recommended Starting Dose (RSD) on the FDA-approved label based on results from clinical trials. However, patients’ ability to tolerate the RSD in the real-world may differ from the clinical trial setting. While the importance of patient reported outcomes is recognized, understanding tolerability from the patient’s perspective is lacking and patients’ willingness to discuss individualized doses for MBC therapy has not been evaluated. Methods: Patient advocates from the Patient-Centered Dosing Initiative distributed a confidential online survey to patients with MBC via social media groups, organizational newsletters, and online support forums. The survey was developed by patients and medical oncologists to ascertain the prevalence and impact of patients’ treatment-related side effects, quality of patient-physician communication, management of side effects, and interest in alternative approaches to the RSD when a new treatment is initiated or adverse side effects are experienced. Results: 1,221 patients with MBC completed the survey within 15 days. The median number of lines of MBC therapy was 2.5 (range 1 - ≥5) and 46% (n = 564) of patients received their MBC diagnosis within two years of taking the survey. 86% (n = 1,051) reported experiencing at least one significant treatment-related side effect, and of these, 20% (n = 213) visited the Emergency Room/hospital and 43% (n = 454) missed at least one treatment. 98% (n = 1,026) of patients with side effects discussed them with their doctors and 82% (n = 838) were helped by their physicians. The most common (non-exclusive) mitigation strategies were dosage reductions (66%, n = 556) and prescription medications (59%, n = 494). Of the 556 patients given a dosage reduction, 83% (n = 459) reported feeling better. Notably, 92% (n = 1,127) of patients expressed willingness to discuss alternative dosing options with their physicians based upon their personal characteristics and individual preferences. Conclusions: Given that 86% of patients with MBC experienced at least one significant treatment-related side effect and 83% improved after dosage reduction, innovative dosage-related strategies are warranted to sustain Quality of Life. Patient-physician discussions in which the patient’s physical attributes and circumstances are periodically assessed may determine the right dose for the patient upon treatment initiation and afterwards, and the vast majority of patients would be receptive to such discussions.