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| Annals of oncology : official journal of the European Society for Medical Oncology. 2019 Jan 23. pii: 5299438. doi: 10.1093/annonc/mdz016 |
| Effects of Neratinib on Health-Related Quality-of-Life in Women with HER2-Positive Early-Stage Breast Cancer: Longitudinal Analyses from the Randomized Phase III ExteNET Trial. |
| Delaloge S1, Cella D2, Ye Y3, Buyse M4, Chan A5, Barrios CH6, Holmes FA7, Mansi J8, Iwata H9, Ejlertsen B10, Moy B11, Chia SKL12, Gnant M13, Smichkoska S14, Ciceniene A15, Martinez N16, Filipovic S17, Ben-Baruch NE18, Joy AA19, Langkjer ST20, Senecal F21, de Boer RH22, Moran S23, Yao B24, Bryce R25, Auerbach A26, Fallowfield L27, Martin M28 |
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Abstract BACKGROUND: We report longitudinal health-related quality-of-life (HRQoL) data from the international, randomized, double-blind, placebo-controlled phase III ExteNET study, which demonstrated an invasive disease-free survival benefit of extended adjuvant therapy with neratinib over placebo in HER2-positive early-stage breast cancer. PATIENTS AND METHODS: Women (N=2840) with early-stage HER2-positive breast cancer who had completed trastuzumab-based adjuvant therapy were randomly assigned to neratinib 240 mg/day or placebo for 12 months. HRQoL was an exploratory endpoint. Patients completed the Functional Assessment of Cancer Therapy-Breast (FACT-B) and EuroQol 5-Dimensions (EQ-5D) questionnaires at baseline and months 1, 3, 6, 9, and 12. Changes from baseline were compared using analysis of covariance with no imputation for missing values. Sensitivity analyses used alternative methods. Changes in HRQoL scores were regarded as clinically meaningful if they exceeded previously reported important differences (IDs). RESULTS: Of the 2840 patients (intention-to-treat population), 2407 patients were evaluable for FACT-B (neratinib, N=1171; placebo, N=1236) and 2427 patients for EQ-5D (neratinib, N=1186; placebo, N=1241). Questionnaire completion rates exceeded 85%. Neratinib was associated with a decrease in global HRQoL scores at month 1 compared with placebo (adjusted mean differences: FACT-B total, -2.9 points; EQ-5D index, ‒0.02), after which between-group differences diminished at later time-points. Except for the FACT-B physical well-being (PWB) subscale at month 1; all between-group differences were less than reported IDs. The FACT-B breast cancer-specific subscale showed small improvements with neratinib at months 3-9, but all were less than IDs. Sensitivity analyses exploring missing data did not change the results. CONCLUSIONS: Extended adjuvant neratinib was associated with a transient, reversible decrease in HRQoL during the first month of treatment, possibly linked to treatment-related diarrhea. With the exception of the PWB subscale at month 1, all neratinib-related HRQoL changes did not reach clinically meaningful thresholds. ClinicalTrials.gov: NCT00878709. |
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Publikations ID: 30689703 Quelle: öffnen |
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