Impact of crizotinib on patient-reported symptoms and quality of life (QOL) compared with single-agent chemotherapy in a phase III study of advanced ALK+ non-small cell lung cancer (NSCLC).

Authors

null

Vera Hirsh

McGill University Health Centre, Montreal, QC, Canada

Vera Hirsh , Fiona Helen Blackhall , Dong-Wan Kim , Benjamin Besse , Hiroshi Nokihara , Ji-Youn Han , Vanessa Roberts Tassell , Arlene Reisman , Shrividya Iyer , Alice Tsang Shaw

Organizations

McGill University Health Centre, Montreal, QC, Canada, The Christie National Health Services Foundation Trust, Manchester, United Kingdom, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea, Institut Gustave Roussy, Villejuif, France, Division of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan, Center for Lung Cancer, National Cancer Center, Goyang, South Korea, Pfizer Oncology, La Jolla, CA, Pfizer Specialty Care, New York, NY, Pfizer Oncology, New York, NY, Massachusetts General Hospital Cancer Center, Boston, MA

Research Funding

Pharmaceutical/Biotech Company

Background: PROFILE 1007 compared the efficacy and safety of the ALK inhibitor crizotinib (N=172) with that of standard-of-care chemotherapy (pemetrexed [PEM; N=99] or docetaxel [DOC; N=72]) in patients with advanced ALK+ NSCLC. The primary endpoint was progression-free survival. The main objective of our present post-hoc analyses was to compare patient-reported outcomes in the crizotinib arm with those of the DOC and PEM subgroups in the chemotherapy arm. Methods: Patient-reported outcomes were assessed at baseline, on day 1 of each cycle, and at the end of treatment using EORTC QLQ-C30 and lung cancer module QLQ-LC13. Higher scores (range 0−100) indicate higher symptom severity or better functioning/QOL. Time to deterioration (TTD) was defined as time from randomization to the earliest time with a ≥10-point increase from baseline for pain in chest, dyspnea, or cough and was compared between groups using an unstratified log-rank test. Repeated measures mixed-effects analyses were performed to compare change from baseline scores, with no adjustment for multiple comparisons. Results: Completion rates at baseline were ≥90% in each group and scores were well balanced. Crizotinib treatment was associated with a significantly longer TTD compared with PEM (median, 5.6 vs. 1.9 mo; HR, 0.66; 95% CI, 0.48−0.92; P=0.013) or DOC (median, 5.6 vs. 0.9 mo; HR, 0.37; 95% CI, 0.26−0.54; P<0.0001). A significantly greater improvement from baseline was observed with crizotinib compared with either the PEM or DOC subgroups for global QOL (P<0.01), cough (P<0.001), dyspnea (P<0.0001), pain in arm or shoulder (P<0.0001), pain in chest (P<0.0001), pain in other parts (P<0.01), fatigue (P<0.05), insomnia (P<0.05), and pain (P<0.0001). A significantly greater improvement was also observed with crizotinib compared with DOC for functioning (P<0.05), alopecia (P<0.0001), and hemoptysis (P<0.0001). Conclusions: Crizotinib treatment showed a significantly greater improvement from baseline in key patient-reported lung cancer symptoms and global QOL compared with DOC and PEM, in addition to improved efficacy previously reported. Clinical trial information: NCT00932893.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer - Non-small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT00932893

Citation

J Clin Oncol 31, 2013 (suppl; abstr 8108)

DOI

10.1200/jco.2013.31.15_suppl.8108

Abstract #

8108

Poster Bd #

40H

Abstract Disclosures