학술논문
Patient-Reported Outcomes in Patients With Advanced Urothelial Cancer Who Are Ineligible for Cisplatin and Treated With First-Line Enfortumab Vedotin Alone or With Pembrolizumab.
Document Type
Academic Journal
Author
Milowsky MI; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.; O'Donnell PH; University of Chicago, Chicago, IL.; Hoimes CJ; Duke Cancer Institute, Duke University, Durham, NC.; Petrylak DP; Yale Cancer Center, New Haven, CT.; Flaig TW; University of Colorado Comprehensive Cancer Center, Aurora, CO.; Moon HH; Kaiser Permanente Southern California, Riverside, CA.; Friedlander TW; University of California San Francisco Medical Center, San Francisco, CA.; Mar N; University of California Irvine, Irvine, CA.; McKay RR; University of California San Diego, San Diego, CA.; Srinivas S; Stanford University Medical Center, Stanford, CA.; Gravis G; Institut Paoli-Calmettes, Marseille, France.; Ramamurthy C; MD Anderson Cancer Center, University of Texas Health, San Antonio, TX.; Bupathi M; Rocky Mountain Cancer Centers, Littleton, CO.; Bracarda S; Azienda Ospedaliera Santa Maria Terni, Terni, Italy.; Wright P; Seagen Inc, Bothell, WA.; Hepp Z; Seagen Inc, Bothell, WA.; Carret AS; Seagen Inc, Bothell, WA.; Yu Y; Seagen Inc, Bothell, WA.; Dillon R; Astellas Pharma Inc, Northbrook, IL.; Kataria R; Merck & Co, Inc, Rahway, NJ.; Beaumont JL; Clinical Outcomes Solutions Ltd, Tucson, AZ.; Purnajo I; Clinical Outcomes Solutions Ltd, Tucson, AZ.; Rosenberg JE; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY.
Source
Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 8309333 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-7755 (Electronic) Linking ISSN: 0732183X NLM ISO Abbreviation: J Clin Oncol Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Locally advanced/metastatic urothelial cancer (la/mUC) affects patients' quality of life (QOL) and functioning. We describe the impact of first-line (1L) enfortumab vedotin (EV) alone or with pembrolizumab (P) on QOL/functioning/symptoms in patients with la/mUC who were cisplatin-ineligible from EV-103 Cohort K.
Methods: In this phase Ib/II trial, patients were randomly assigned 1:1 to EV + P or EV monotherapy (mono). Exploratory patient-reported outcomes (PROs) were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire (EORTC QLQ-C30) and Brief Pain Inventory Short Form (BPI-SF) at baseline, once per week for cycles 1-3, and then in every cycle through the end of treatment. Changes in scores from baseline to week 24, reported as least squares mean (standard error), were assessed by mixed models for repeated measures. There were no formal statistical comparisons between treatment arms.
Results: Of 149 patients treated, 65 (EV + P) and 63 (EV mono) comprised the PRO analysis set. For EV + P, EORTC QLQ-C30 QOL was maintained through week 24 with improvements in emotional functioning, pain, and insomnia. Clinically meaningful improvements were seen in EORTC QLQ-C30 pain after EV + P at weeks 12 (-14.41 [3.14]) and 24 (-14.99 [3.56]) and BPI-SF worst pain at week 24 (-2.07 [0.37]). For EV mono, EORTC QLQ-C30 QOL remained stable with clinically meaningful improvements in EORTC QLQ-C30 pain (-12.55 [4.27]), insomnia (-14.46 [4.69]), and constipation (-10.09 [4.35]) at week 24. There were small-to-moderate improvements in BPI-SF worst pain at week 24.
Conclusion: EV + P in patients with la/mUC who were cisplatin-ineligible was associated with preservation or improvement of QOL/functioning/symptoms. Improvement in pain was seen in both PRO instruments and treatment arms. These data complement clinical outcomes of 1L EV + P.
Methods: In this phase Ib/II trial, patients were randomly assigned 1:1 to EV + P or EV monotherapy (mono). Exploratory patient-reported outcomes (PROs) were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core Questionnaire (EORTC QLQ-C30) and Brief Pain Inventory Short Form (BPI-SF) at baseline, once per week for cycles 1-3, and then in every cycle through the end of treatment. Changes in scores from baseline to week 24, reported as least squares mean (standard error), were assessed by mixed models for repeated measures. There were no formal statistical comparisons between treatment arms.
Results: Of 149 patients treated, 65 (EV + P) and 63 (EV mono) comprised the PRO analysis set. For EV + P, EORTC QLQ-C30 QOL was maintained through week 24 with improvements in emotional functioning, pain, and insomnia. Clinically meaningful improvements were seen in EORTC QLQ-C30 pain after EV + P at weeks 12 (-14.41 [3.14]) and 24 (-14.99 [3.56]) and BPI-SF worst pain at week 24 (-2.07 [0.37]). For EV mono, EORTC QLQ-C30 QOL remained stable with clinically meaningful improvements in EORTC QLQ-C30 pain (-12.55 [4.27]), insomnia (-14.46 [4.69]), and constipation (-10.09 [4.35]) at week 24. There were small-to-moderate improvements in BPI-SF worst pain at week 24.
Conclusion: EV + P in patients with la/mUC who were cisplatin-ineligible was associated with preservation or improvement of QOL/functioning/symptoms. Improvement in pain was seen in both PRO instruments and treatment arms. These data complement clinical outcomes of 1L EV + P.