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10-19-2013, 07:33 PM
Oncologist. (http://www.ncbi.nlm.nih.gov/pubmed/23814044#) 2013;18(7):812-8. doi: 10.1634/theoncologist.2013-0091. Epub 2013 Jun 28.
Health-related quality of life with adjuvant docetaxel- and trastuzumab-based regimens in patients with node-positive and high-risk node-negative, HER2-positive early breast cancer: results from the BCIRG 006 Study.
Au HJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Au%20HJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Eiermann W (http://www.ncbi.nlm.nih.gov/pubmed?term=Eiermann%20W%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Robert NJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Robert%20NJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pienkowski T (http://www.ncbi.nlm.nih.gov/pubmed?term=Pienkowski%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Crown J (http://www.ncbi.nlm.nih.gov/pubmed?term=Crown%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Martin M (http://www.ncbi.nlm.nih.gov/pubmed?term=Martin%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pawlicki M (http://www.ncbi.nlm.nih.gov/pubmed?term=Pawlicki%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Chan A (http://www.ncbi.nlm.nih.gov/pubmed?term=Chan%20A%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Mackey J (http://www.ncbi.nlm.nih.gov/pubmed?term=Mackey%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Glaspy J (http://www.ncbi.nlm.nih.gov/pubmed?term=Glaspy%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pintér T (http://www.ncbi.nlm.nih.gov/pubmed?term=Pint%C3%A9r%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Liu MC (http://www.ncbi.nlm.nih.gov/pubmed?term=Liu%20MC%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Fornander T (http://www.ncbi.nlm.nih.gov/pubmed?term=Fornander%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Sehdev S (http://www.ncbi.nlm.nih.gov/pubmed?term=Sehdev%20S%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Ferrero JM (http://www.ncbi.nlm.nih.gov/pubmed?term=Ferrero%20JM%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Bée V (http://www.ncbi.nlm.nih.gov/pubmed?term=B%C3%A9e%20V%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Santana MJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Santana%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Miller DP (http://www.ncbi.nlm.nih.gov/pubmed?term=Miller%20DP%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Lalla D (http://www.ncbi.nlm.nih.gov/pubmed?term=Lalla%20D%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Slamon DJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Slamon%20DJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044); Translational Research in Oncology BCIRG 006 Trial Investigators (http://www.ncbi.nlm.nih.gov/pubmed?term=Translational%20Research%20in%20Oncolo gy%20BCIRG%20006%20Trial%20Investigators%5BCorpora te%20Author%5D).
Source
Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND:
This study aims to describe and compare health-related quality of life (HRQL) in patients with node-positive and high-risk node-negative HER2-positive early breast cancer receiving adjuvant docetaxel and trastuzumab-based or docetaxel-based regimens alone.
METHODS:
Eligible patients (n = 3,222) were randomly assigned to either four cycles of adjuvant doxorubicin and cyclophosphamide followed by four cycles of docetaxel (AC→T) or one of two trastuzumab-containing regimens: adjuvant doxorubicin and cyclophosphamide followed by docetaxel plus trastuzumab administered for 1 year (AC→TH) or six cycles of docetaxel plus carboplatin combined with trastuzumab administered for 1 year (TCH). The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and BR-23 were administered at baseline, the start of cycle 4 (mid), and the end of chemotherapy (EOC), as well as at 6, 12, and 24 months after chemotherapy.
RESULTS:
Compliance rates for the EORTC questionnaires were acceptable at 72%-93% of eligible patients out to the 12-month assessment. Systemic side effect (SE) change scores were significantly improved for TCH-treated patients compared with AC→TH and AC→T at EOC, suggesting improved tolerability. Physical functioning (PF) was only slightly worse at midpoint for those receiving TCH, compared with patients who were just starting on taxane in an AC→TH regimen, but was otherwise similar between arms. All treatment arms recovered from the deterioration in SE, PF, and Global Health Scale scores by 1 year and median future perspective change scores continued to improve throughout treatment and follow-up.
CONCLUSION:
HRQL outcomes for adjuvant docetaxel and trastuzumab-based regimens are favorable and support TCH as a more tolerable treatment option.
Health-related quality of life with adjuvant docetaxel- and trastuzumab-based regimens in patients with node-positive and high-risk node-negative, HER2-positive early breast cancer: results from the BCIRG 006 Study.
Au HJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Au%20HJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Eiermann W (http://www.ncbi.nlm.nih.gov/pubmed?term=Eiermann%20W%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Robert NJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Robert%20NJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pienkowski T (http://www.ncbi.nlm.nih.gov/pubmed?term=Pienkowski%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Crown J (http://www.ncbi.nlm.nih.gov/pubmed?term=Crown%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Martin M (http://www.ncbi.nlm.nih.gov/pubmed?term=Martin%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pawlicki M (http://www.ncbi.nlm.nih.gov/pubmed?term=Pawlicki%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Chan A (http://www.ncbi.nlm.nih.gov/pubmed?term=Chan%20A%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Mackey J (http://www.ncbi.nlm.nih.gov/pubmed?term=Mackey%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Glaspy J (http://www.ncbi.nlm.nih.gov/pubmed?term=Glaspy%20J%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Pintér T (http://www.ncbi.nlm.nih.gov/pubmed?term=Pint%C3%A9r%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Liu MC (http://www.ncbi.nlm.nih.gov/pubmed?term=Liu%20MC%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Fornander T (http://www.ncbi.nlm.nih.gov/pubmed?term=Fornander%20T%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Sehdev S (http://www.ncbi.nlm.nih.gov/pubmed?term=Sehdev%20S%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Ferrero JM (http://www.ncbi.nlm.nih.gov/pubmed?term=Ferrero%20JM%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Bée V (http://www.ncbi.nlm.nih.gov/pubmed?term=B%C3%A9e%20V%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Santana MJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Santana%20MJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Miller DP (http://www.ncbi.nlm.nih.gov/pubmed?term=Miller%20DP%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Lalla D (http://www.ncbi.nlm.nih.gov/pubmed?term=Lalla%20D%5BAuthor%5D&cauthor=true&cauthor_uid=23814044), Slamon DJ (http://www.ncbi.nlm.nih.gov/pubmed?term=Slamon%20DJ%5BAuthor%5D&cauthor=true&cauthor_uid=23814044); Translational Research in Oncology BCIRG 006 Trial Investigators (http://www.ncbi.nlm.nih.gov/pubmed?term=Translational%20Research%20in%20Oncolo gy%20BCIRG%20006%20Trial%20Investigators%5BCorpora te%20Author%5D).
Source
Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
Abstract
BACKGROUND:
This study aims to describe and compare health-related quality of life (HRQL) in patients with node-positive and high-risk node-negative HER2-positive early breast cancer receiving adjuvant docetaxel and trastuzumab-based or docetaxel-based regimens alone.
METHODS:
Eligible patients (n = 3,222) were randomly assigned to either four cycles of adjuvant doxorubicin and cyclophosphamide followed by four cycles of docetaxel (AC→T) or one of two trastuzumab-containing regimens: adjuvant doxorubicin and cyclophosphamide followed by docetaxel plus trastuzumab administered for 1 year (AC→TH) or six cycles of docetaxel plus carboplatin combined with trastuzumab administered for 1 year (TCH). The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and BR-23 were administered at baseline, the start of cycle 4 (mid), and the end of chemotherapy (EOC), as well as at 6, 12, and 24 months after chemotherapy.
RESULTS:
Compliance rates for the EORTC questionnaires were acceptable at 72%-93% of eligible patients out to the 12-month assessment. Systemic side effect (SE) change scores were significantly improved for TCH-treated patients compared with AC→TH and AC→T at EOC, suggesting improved tolerability. Physical functioning (PF) was only slightly worse at midpoint for those receiving TCH, compared with patients who were just starting on taxane in an AC→TH regimen, but was otherwise similar between arms. All treatment arms recovered from the deterioration in SE, PF, and Global Health Scale scores by 1 year and median future perspective change scores continued to improve throughout treatment and follow-up.
CONCLUSION:
HRQL outcomes for adjuvant docetaxel and trastuzumab-based regimens are favorable and support TCH as a more tolerable treatment option.