Abstract GS6-03: Symptoms and health-related quality of life on endocrine therapy alone (E) versus chemoendocrine therapy (C+E): TAILORx patient-reported outcomes results

L. Wagner, R. Gray, S. Garcia, T. Whelan, A. Tevarweerk, B. Yanez, R. Carlos, I. Gareen, W. McCaskill-Stevens, D. Cella, J. Sparano, G. Sledge
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引用次数: 10

Abstract

Background: TAILORx patient-reported outcomes (PRO) quantify symptoms and health-related quality of life (HRQL) from C+E beyond E alone from the patient9s perspective, thus can inform decision-making for women in the intermediate risk group for whom chemotherapy may still be considered. Methods: TAILORx participants with OncoType DX Recurrence Scores 11-25 were randomly assigned to E or C+E. All TAILORx participants enrolled 1/2010-10/2010 (N=612) completed PROs measuring fatigue, endocrine symptoms, cognitive impairments (PCI), and fear of recurrence at baseline, 3, 6, 12, 24 and 36 months. HRQL was assessed at baseline, 12, and 36 months. Linear regression (LR) examined PRO scores among the per-protocol sample. Results: Overall, participants reported significantly more fatigue, endocrine symptoms and PCI at 3, 6, 12, 24 and 36 months compared to baseline and those randomized to C+E reported a greater magnitude of change baseline-3 months compared to those randomized to E alone (Table 1). Overall, by 12 months symptoms were comparable between groups. Pre-menopausal women had comparable symptoms at 24 and 36 months. Post-menopausal women randomized to C+E had greater endocrine symptoms at 24 and 36 months and greater fatigue at 6 and 24 months. Fear of recurrence was comparable between arms during treatment and follow-up. Multiple linear regression identified increased fatigue (LR slope β=0.67), endocrine symptoms (β =0.14), and PCI (β=0.11) as significant predictors of decreased HRQL across arms (p Conclusions: TAILORx is the first trial to examine patient-reported fatigue, endocrine symptoms, PCI and HRQL among breast cancer patients randomized to endocrine therapy alone vs chemoendocrine therapy, thus allowing us to quantify acute and long-term symptoms uniquely attributable to chemotherapy. As expected, chemotherapy is associated with greater fatigue, endocrine symptoms and PCI acutely during treatment, and for post-menopausal women with greater long-term endocrine symptoms. Increased symptoms were associated with poorer HRQL. Long-term HRQL was comparable between groups. Citation Format: Wagner LI, Gray RJ, Garcia S, Whelan TJ, Tevarweerk A, Yanez B, Carlos R, Gareen I, McCaskill-Stevens W, Cella D, Sparano JA, Sledge, Jr. GW, On behalf of the TAILORx Study Team. Symptoms and health-related quality of life on endocrine therapy alone (E) versus chemoendocrine therapy (C+E): TAILORx patient-reported outcomes results [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS6-03.
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GS6-03:单独内分泌治疗(E)与化疗内分泌治疗(C+E)的症状和健康相关生活质量:TAILORx患者报告的结果
背景:从患者的角度出发,TAILORx患者报告结局(PRO)从C+E而不仅仅是E来量化症状和健康相关生活质量(HRQL),因此可以为中等风险组中仍可能考虑化疗的妇女提供决策依据。方法:将OncoType DX复发评分为11-25分的TAILORx参与者随机分为E组或C+E组。所有入选的受试者(N=612)在基线、3、6、12、24和36个月完成了疲劳、内分泌症状、认知障碍(PCI)和复发恐惧的PROs测量。在基线、12个月和36个月时评估HRQL。线性回归(LR)检查每个方案样本的PRO分数。结果:总体而言,与基线相比,参与者在3、6、12、24和36个月时报告的疲劳、内分泌症状和PCI明显增加,随机分配到C+E组的参与者在基线-3个月时报告的变化幅度大于随机分配到E组的参与者(表1)。总体而言,12个月时各组之间的症状具有可比性。绝经前妇女在24个月和36个月时也有类似的症状。绝经后妇女随机分为C+E组,在第24和36个月时内分泌症状加重,在第6和24个月时疲劳加重。在治疗和随访期间,两组患者对复发的恐惧程度具有可比性。多元线性回归发现疲劳增加(LR斜率β=0.67)、内分泌症状(β= 0.14)和PCI (β=0.11)是各组HRQL下降的重要预测因子(p)。结论:TAILORx是第一个在随机分配到单独内分泌治疗与化疗内分泌治疗的乳腺癌患者中检查患者报告的疲劳、内分泌症状、PCI和HRQL的试验,从而使我们能够量化化疗引起的急性和长期症状。正如预期的那样,化疗与治疗期间更严重的疲劳、内分泌症状和PCI急性相关,并且对于绝经后妇女有更大的长期内分泌症状。症状加重与较差的HRQL相关。两组间长期HRQL具有可比性。引用格式:Wagner LI, Gray RJ, Garcia S, Whelan TJ, Tevarweerk A, Yanez B, Carlos R, Gareen I, mccasgill - stevens W, Cella D, Sparano JA, Sledge, Jr. GW,代表TAILORx研究团队。单独内分泌治疗(E)与化学内分泌治疗(C+E)的症状和健康相关生活质量:TAILORx患者报告的结果[摘要]。2018年圣安东尼奥乳腺癌研讨会论文集;2018年12月4-8日;费城(PA): AACR;癌症杂志,2019;79(4增刊):摘要nr GS6-03。
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