Patient- versus clinician-reported symptoms in the POLARIX study.

Authors

null

Carrie A. Thompson

Mayo Clinic College of Medicine, Rochester, MN

Carrie A. Thompson , Neha Mehta-Shah , Christopher Flowers , Gilles A. Salles , Herve Tilly , Neil Sun Chua , René-Olivier Casasnovas , Fiona Miall , Tae Min Kim , Cheng-Hong Tsai , Sunita Dwivedy Nasta , Seung Tae Lee , Veronica Craine , Avrita Campinha-Bacote , Jamie H. Hirata , Calvin Lee , Matthew Dean Sei Sugidono , Jonathan W. Friedberg

Organizations

Mayo Clinic College of Medicine, Rochester, MN, Washington University School of Medicine, St. Louis, MO, The University of Texas MD Anderson Cancer Center, Houston, TX, Memorial Sloan Kettering Cancer Center, New York, NY, Centre Henri-Becquerel and University of Rouen, Rouen, France, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada, CHU Dijon Bourgogne, Dijon, France, Department of Haematology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom, Seoul National University Hospital, Seoul, South Korea, National Taiwan University Hospital, Taipei, Taiwan, University of Pennsylvania Hospital, Philadelphia, PA, University of Maryland School of Medicine, Baltimore, MD, Hoffmann-La Roche Ltd, Mississauga, ON, Canada, Genentech, Inc., South San Francisco, CA, Wilmot Cancer Institute, University of Rochester, Rochester, NY

Research Funding

Pharmaceutical/Biotech Company
The POLARIX study (NCT03274492) was sponsored by F. Hoffmann-La Roche Ltd and Genentech, Inc. Third-party editorial assistance was provided by Leen Al-Mohammad, BSc, of Ashfield MedComms, an Inizio company, and was funded by F. Hoffmann-La Roche Ltd

Background: The safety profiles of novel agents are mainly based on clinician-reported adverse events (AEs) from clinical trials. Patient-reported outcomes (PROs) may better represent the treatment burden experienced by patients (pts) compared with clinician-reported AEs. Using data from POLARIX, a double-blind, placebo-controlled, randomized Phase 3 international study (NCT03274492), we previously presented PRO and clinician-reported data showing similar rates of neuropathy (Trněný et al. 2022). Here, we evaluate the reporting of other common symptoms using PRO and clinician-reported data in POLARIX. Methods: POLARIX methods were previously described (Tilly et al. 2022); this analysis included all pts with PRO data. PRO and clinician-reported data described the incidence and severity of fatigue, constipation, diarrhea, nausea, and vomiting. Clinician-reported severity grading was based on the NCI Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.0. PROs were collected using the European Organisation Research and Treatment of Cancer Quality of Life-Core 30 questionnaire (EORTC QLQ-C30), which was administered to pts at clinic visits on Day 1 of Cycles 1 (baseline), 2, 3, and 5, and end of treatment (EOT). PRO severity scores included ‘A little’, ‘Quite a bit’, and ‘Very much’. Results: Overall, 825 pts were evaluable. From baseline to EOT, PROs showed a higher incidence of symptoms compared with clinicians for fatigue (98% vs 27%), constipation (68% vs 29%), diarrhea (56% vs 26%), nausea (58% vs 40%), and vomiting (24% vs 15%). PRO severity scores of ‘Quite a bit’ or ‘Very much’ were reported in 33% of pts for fatigue, 29% for constipation, 17% for diarrhea, 19% for nausea, and 7% for vomiting. Clinicians reported Grade ≥2 symptoms in 11% of pts for fatigue, 11% for constipation, 11% for diarrhea, 14% for nausea, and 6% for vomiting. Conclusions: In POLARIX, pts reported a higher incidence and severity of symptoms compared with clinicians. Although distinct scales were used, the differences in symptom rates reported by pts and clinicians were clinically meaningful. These data may have implications for symptom management, including physician evaluation and communication of symptom expectations for pts. Reporting of symptoms by PROs should be incorporated into clinical trials as an adjunct to standard AE reporting to better characterize the patient experience. Clinical trial information: NCT03274492.

Symptom,* n (%)Clinician-reported severity,
Grade ≥2
Patient-reported severity,
‘A little’
Patient-reported severity,
‘Quite a bit’
Patient-reported severity,
‘Very much’
Fatigue88 (10.7)532 (64.6)245 (29.7)28 (3.4)
Constipation93 (11.3)330 (40.2)143 (17.4)91 (11.1)
Diarrhea87 (10.5)316 (38.4)90 (10.9)52 (6.3)
Nausea119 (14.4)317 (38.5)112 (13.6)46 (5.6)
Vomiting46 (5.6)143 (17.4)33 (4.0)25 (3.0)

PRO-evaluable population: n=825. *From baseline to EOT; Based on NCI-CTCAE v4.0; Based on EORTC QLQ-C30.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Palliative Care and Symptom Management

Clinical Trial Registration Number

NCT03274492

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 12100)

DOI

10.1200/JCO.2023.41.16_suppl.12100

Abstract #

12100

Poster Bd #

468

Abstract Disclosures

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