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Type: Journal article
Title: Health-related quality of life associated with regorafenib treatment in refractory advanced gastric adenocarcinoma
Author: Martin, A.
Gibbs, E.
Sjoquist, K.
Pavlakis, N.
Simes, J.
Price, T.
Shannon, J.
Gill, S.
Jain, V.
Liu, G.
Kannourakis, G.
Kim, Y.
Kim, J.
Goldstein, D.
Citation: Gastric Cancer, 2018; 21(3):473-480
Publisher: Springer Japan
Issue Date: 2018
ISSN: 1436-3291
Statement of
Andrew J. Martin, Emma Gibbs, Katrin Sjoquist, Nick Pavlakis, John Simes, Tim Price, Jenny Shannon, Sanjeev Gill, Vikram Jain, Geoffrey Liu, George Kannourakis, Yeul Hong Kim, Jin Won Kim, David Goldstein, On behalf of the INTEGRATE I investigators
Abstract: Background: The INTEGRATE phase II multinational randomized controlled trial demonstrated the activity of regorafenib on progression-free survival (PFS) in patients with refractory advanced gastric adenocarcinoma. We sought to evaluate whether these PFS gains had the potential to be offset by quality of life (QoL) impacts from treatment side effects and to thereby determine the appropriateness of continuing development to phase III. Methods: QoL was assessed in INTEGRATE at baseline and at each 4 weeks thereafter, until discontinuation of study treatment, using the QLQ-C30, STO22, and EQ-5D questionnaires. The patient disease and treatment assessment (PTDATA) form was also provided to English-speaking participants. Randomized groups were compared on the QLQ-C30, STO22, and EQ-5D scales using a repeated-measures model; the frequency of troublesome symptoms and side effects measured by the PTDATA form; and deterioration-free survival (DFS). The prognostic value of baseline QoL information was also evaluated. Results: Of the 147 eligible randomized patients, 142 consented to participate in the QoL substudy, 136 completed a baseline QoL assessment, and 95 completed at least one post-baseline QoL assessment. The DFS rate was significantly improved with regorafenib, and there was no compelling statistical evidence that regorafenib had a broad negative effect across the spectrum of QoL indices evaluated. Fatigue, anxiety, appetite loss, and pain were among the issues most commonly reported for both randomized groups. Baseline levels of pain, appetite, constipation, and physical functioning were prognostic factors for survival. Conclusions: Regorafenib improved DFS without an excessively negative effect on QoL. Progressing development to the phase III setting is warranted.
Keywords: Quality of life; stomach neoplasms; antineoplastic agents/therapeutic use; protein kinase inhibitors/therapeutic use
Description: Published online: 16 August 2017
Rights: © The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2017
DOI: 10.1007/s10120-017-0754-1
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