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Health-Related Quality of Life in Patients with Advanced Nonsquamous Non-Small-Cell Lung Cancer Receiving Bevacizumab or Bevacizumab-Plus-Pemetrexed Maintenance Therapy in AVAPERL (MO22089)
Lungenfachklin Immenhausen, Germany .
NN Blokhin Cancer Research Centre Russia, Russia .
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
CHRU Lille, France .
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2013 (English)In: Journal of Thoracic Oncology, ISSN 1556-0864, Vol. 8, no 11, 1409-1416 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: In the phase III AVAPERL trial, patients with advanced nonsquamous non-small-cell lung cancer receiving bevacizumab-plus-pemetrexed maintenance after first-line induction had a significant progression-free survival benefit relative to those treated with single-agent bevacizumab maintenance but with an increase in grade 3 adverse events. Here, we compare health-related quality of life (HRQOL) between AVAPERL maintenance arms. less thanbrgreater than less thanbrgreater thanMethods: Patient-reported outcomes were collected at designated intervals from preinduction to final visits. HRQOL was assessed using the self-administered European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Quality of Life Lung Cancer-Specific Module 13. Differences in scores of 10 points or more between arms were above the minimum important difference threshold and considered clinically meaningful. less thanbrgreater than less thanbrgreater thanResults: During induction, patient-reported coughing symptoms improved slightly, whereas fatigue and appetite loss scores worsened relative to preinduction baseline. During maintenance, changes in mean global health status and the majority of Quality of Life Questionnaire Core 30 and Quality of Life Lung Cancer-Specific Module 13 subscale scores did not differ between trial arms by the minimum important difference defining clinically meaningful (better or worse) patient-reported outcomes. Exceptions were patient-reported role functional status, fatigue symptoms and appetite loss symptoms (favoring bevacizumab), and pain in arm or shoulder symptoms (favoring bevacizumab-plus-pemetrexed maintenance), which differed by clinically meaningful amounts at more than one maintenance assessment. less thanbrgreater than less thanbrgreater thanConclusions: In AVAPERL, HRQOL remained relatively stable throughout maintenance and was generally similar in both arms. Despite an increase in adverse event rates, the addition of pemetrexed to bevacizumab maintenance resulted in similar stabilization of disease symptoms with improved efficacy outcomes.

Place, publisher, year, edition, pages
Lippincott, Williams and Wilkins , 2013. Vol. 8, no 11, 1409-1416 p.
Keyword [en]
Patient-reported outcomes, Non-small-cell lung cancer, Bevacizumab, Pemetrexed, AVAPERL, Maintenance
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-100907DOI: 10.1097/JTO.0b013e3182a46bcfISI: 000326026000021OAI: diva2:664351

Funding Agencies|F. Hoffmann-La Roche Ltd.||

Available from: 2013-11-14 Created: 2013-11-14 Last updated: 2014-03-14

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Vikström, Anders
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Department of Clinical and Experimental MedicineFaculty of Health SciencesDepartment of Respiratory Medicine
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