|
1
|
Ahmad AS, Doss JG, Ismail SM, Chen Kiong S, Jelon MA, Thangavalu L, Lay Ling C. Quality of Life vs. Supportive Care Needs for Oral Cancer Caregivers: Are They Related? Curr Oncol 2023; 30:1733-1744. [PMID: 36826095 PMCID: PMC9954937 DOI: 10.3390/curroncol30020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Caregivers providing care for their family members with oral cancer usually endure the caregiving burden in silence, which affects their quality of life and necessitates the need for supportive care. The aim of this study is to determine the relationship between the quality of life (QOL) of oral cancer caregivers and their supportive care needs (SCN) in Malaysia. The Malaysian versions of the Caregiver Oncology Quality of Life Questionnaire (M-CarGOQoL) and the Comprehensive Needs Assessment Tool for Cancer Caregivers (M-CNAT-C) were self-administered by 56 family caregivers of oral cancer patients from five tertiary hospitals throughout Peninsular Malaysia and Sarawak between October and December 2021. Correlation and multiple regression analyses were employed, and the significance level was set at p < 0.05. The mean score for the QOL of caregivers was 76.16 ± 16.01, with the lowest scores in the psychological well-being (64.87 ± 30.12) and self-esteem (68.64 ± 28.29) domains. The mean score for SCN of caregivers was 36.42 ± 24.16, with the highest scores in the healthcare staff (58.44 ± 33.80) and information (55.35 ± 29.98) domains. The correlation between QOL and SCN was moderately inversed, (r(54) = 0.58, p < 0.01). There was a significant effect of caregiving duration (<3 h/day versus >3 h/day) on the combined dependent variables (QOL and SCN), F(2, 53) = 5.006, p < 0.01, partial η2 = 0.16. QOL and caregiving duration accounted for a significant 43% of SCN, R2 = 0.43, adjusted R2 = 0.41, F(2, 53) = 20.32, p < 0.01. In conclusion, oral cancer caregivers with poorer QOL have higher SCN. It is recommended that oral cancer caregivers be recognized by healthcare providers in order to deliver holistic patient care.
Collapse
Affiliation(s)
- Aira Syazleen Ahmad
- Oral Health Program, Ministry of Health, Federal Government Administrative Centre, Putrajaya 62590, Malaysia
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
- Oral Cancer Research & Coordinating Centre, University of Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: ; Tel.: +603-7967-4805
| | - Siti Mazlipah Ismail
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Shim Chen Kiong
- Department of Oral and Maxillofacial Surgery, Sarawak General Hospital, Kuching 93586, Malaysia
| | - Md Arad Jelon
- Department of Oral and Maxillofacial Surgery, Kuala Lumpur Hospital, Kuala Lumpur 50586, Malaysia
| | - Logesvari Thangavalu
- Department of Oral and Maxillofacial Surgery, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Ch’ng Lay Ling
- Department of Oral and Maxillofacial Surgery, Seberang Jaya Hospital, Perai 13700, Malaysia
| |
Collapse
|
|
2
|
Elzeneini M, Osman A, Bright K, Yang S, Guo Y, Jeng E, Shah KB. Caregiver Stress Is Improved and Sustained Following Transcatheter Aortic Valve Replacement. Palliat Med Rep 2023; 4:56-58. [PMID: 36910451 PMCID: PMC9994443 DOI: 10.1089/pmr.2022.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 02/26/2023] Open
Abstract
Background Little is known about the impact of symptomatic aortic stenosis and subsequent transcatheter aortic valve replacement (TAVR) on stress and health for the caregiver. In this prospective cohort study, we measured caregiver stress before and after TAVR. Methods We interviewed 34 primary caregivers for patients undergoing outpatient TAVR at an academic institution. Caregiver stress was measured using the Kingston Caregiver Stress Scale (KCSS) and the Caregiver Self-Assessment Questionnaire (CSAQ) before TAVR and at one and six months after. Mean scores were compared pre- and post-TAVR using the Wilcoxon signed-rank test. Results There was significant improvement in KCSS caregiver stress at one month that was sustained at six months post-TAVR (mean change -1.91 ± 2.50 for six months, p-value 0.01). This was primarily driven by improvement in caregiving issues rather than family or financial issues. There was also significant improvement in CSAQ self-assessed health/illness at one and six months (mean change -2.78 ± 4.01 for six months, p-value 0.016). Conclusions Our findings support further investigation of caregiver outcomes in shared decision making before TAVR.
Collapse
Affiliation(s)
- Mohammed Elzeneini
- Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Alfaroug Osman
- Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Khadija Bright
- Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Shuang Yang
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Eric Jeng
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida, USA
| | - Khanjan B Shah
- Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
|
3
|
Ma S, Olchanski N, Cohen JT, Ollendorf DA, Neumann PJ, Kim DD. The Impact of Broader Value Elements on Cost-Effectiveness Analysis: Two Case Studies. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1336-1343. [PMID: 35315331 DOI: 10.1016/j.jval.2022.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/29/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to explore the impact of including broader value elements in cost-effectiveness analyses by presenting 2 case studies, one on human papillomavirus (HPV) infection and one on early-stage Hodgkin's lymphoma (ESHL). METHODS We identified broader value elements (eg, patient and caregiver time, spillover health effects, productivity) from the Second Panel's Impact Inventory and the ISPOR Special Task Force's value flower. We then evaluated the cost-effectiveness of HPV vaccination versus no vaccination (case 1) and combined modality therapy (CMT) versus chemotherapy alone for treatment of adult ESHL (case 2) using published simulation models. For each case study, we compared incremental cost-effectiveness ratios considering health sector impacts only (the "base-case" scenario) with incremental cost-effectiveness ratios incorporating broader value elements. RESULTS For vaccination of US girls against HPV before sexual debut versus no vaccination, the base-case result was $38 334 per disability-adjusted life-year averted. Including each broader value element made cost-effectiveness progressively more favorable, with HPV vaccination becoming cost-saving (ie, reducing costs and averting more disability-adjusted life-years) when the analysis incorporated productivity costs. For CMT versus chemotherapy alone in patients with ESHL, the base-case result indicated that CMT was cost-saving. Including all elements made this treatment's net monetary benefits (the sum of its averted resource costs and the net value of its health impacts) less favorable, even as the contribution from CMT's near-term health benefits grew. CONCLUSIONS Including broader value elements can substantially influence cost-effectiveness ratios, although the direction and the magnitude of their impact can differ across interventions and disease context.
Collapse
Affiliation(s)
- Siyu Ma
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
| | - Natalia Olchanski
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Joshua T Cohen
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Daniel A Ollendorf
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Peter J Neumann
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - David D Kim
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| |
Collapse
|
|
4
|
Grimm M, Radcliff L, Giles M, Nash R, Holley E, Panda S, Brophy L, Williams N, Cherian M, Stover D, Gatti-Mays ME, Wesolowski R, Sardesai S, Sudheendra P, Reinbolt R, Ramaswamy B, Pariser A. Living with Advanced Breast Cancer: A Descriptive Analysis of Survivorship Strategies. J Clin Med 2022; 11:jcm11143992. [PMID: 35887755 PMCID: PMC9319697 DOI: 10.3390/jcm11143992] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Survivors of advanced breast cancer (ABC), also known as metavivors, are often left with fewer treatment options in the landscape of a cure culture. Metavivors have unique psychosocial and physical needs distinct from patients with early-stage breast cancer. This analysis delves into side effects commonly experienced by patients with ABC, such as fatigue, anxiety, and cardiotoxicity; how these side effects impact caregiver support, financial toxicity, emotional strain, and spiritual and emotional distress; as well as current strategies for mitigation, including nutrition, exercise, and participation in clinical research. Overall, this analysis is a mandate for additional research to explore novel treatments and implement strategies to maintain and improve patients’ quality of life.
Collapse
Affiliation(s)
- Michael Grimm
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lindsey Radcliff
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mariann Giles
- Family Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Ryan Nash
- Center for Bioethics and Medical Humanities, The Ohio State University, Columbus, OH 43210, USA;
| | - Erin Holley
- Nutrition and Dietetics, The Ohio State University, Columbus, OH 43210, USA;
| | - Shannon Panda
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lynne Brophy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Nicole Williams
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mathew Cherian
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Daniel Stover
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Margaret E. Gatti-Mays
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Robert Wesolowski
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Sagar Sardesai
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Preeti Sudheendra
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Raquel Reinbolt
- Internal Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Bhuvaneswari Ramaswamy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Ashley Pariser
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
- Correspondence: ; Tel.: +1-614-293-6401
| |
Collapse
|
|
5
|
Howard AF, Torrejón MJ, Lynch K, Beck SM, Thorne S, Lambert L, Porcino A, De Vera MA, Davies JM, Avery J, Wolff AC, McDonald M, Lee JWK, Hedges P, Kelly MT, McKenzie M. To share or not to share: communication of caregiver-reported outcomes when a patient has colorectal cancer. J Patient Rep Outcomes 2022; 6:13. [PMID: 35122565 PMCID: PMC8817655 DOI: 10.1186/s41687-022-00418-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The importance of patient-centered measurement in cancer care has led to recognition of the potential for caregiver-reported outcomes to improve caregiver, patient and healthcare system outcomes. Yet, there is limited evidence to inform caregiver-reported outcome implementation. Our purpose was to generate evidence to inform the meaningful and constructive integration of caregiver-reported outcomes into cancer care to benefit caregivers, including exploration of the question of the extent to which these assessments should be shared with patients. We focused on caregivers of patients with colorectal cancer (CRC) because CRC is common, and associated caregiving can be complex. RESULTS From our Interpretive Description analysis of qualitative interview data from 78 participants (25 caregivers, 37 patients, and 16 healthcare providers [HCPs]), we identified contrasting perspectives about the sharing of caregiver-reported outcome assessments with patients with CRC. Those who preferred open communication with both the patient and caregiver present considered this essential for supporting the caregiver. The participants who preferred private communication without the patient, cited concern about caregiver- and patient-burden and guilt. Recognizing these perspectives, HCPs described strategies used to navigate sensitivities inherent in preferences for open versus private communication. CONCLUSIONS The integration of caregiver-reported outcomes into cancer care will require careful consideration of caregiver and patient preferences regarding the communication of caregiver assessments to prevent additional burden.
Collapse
Affiliation(s)
- A Fuchsia Howard
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada.
| | | | - Kelsey Lynch
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
| | - Scott M Beck
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
- BC Cancer, Vancouver, BC, V5Z 4C2, Canada
| | - Sally Thorne
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
| | - Leah Lambert
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
- BC Cancer, Vancouver, BC, V5Z 4C2, Canada
| | | | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Janine M Davies
- BC Cancer, Vancouver, BC, V5Z 4C2, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Jonathan Avery
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
| | - Angela C Wolff
- School of Nursing, Trinity Western University, Langley, BC, V2Y 1Y1, Canada
| | | | | | | | - Mary T Kelly
- School of Nursing, The University of British Columbia, T201-2211 Wesbrook Mall, , Vancouver, BC, V6T 2B5, Canada
| | - Michael McKenzie
- BC Cancer, Vancouver, BC, V5Z 4C2, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| |
Collapse
|
|
6
|
Loke L, Lee SC, Pearce F, Ng K, Aziz MIA. Cost-effectiveness of ribociclib as initial treatment for premenopausal women with advanced breast cancer in Singapore. Cancer Rep (Hoboken) 2020; 4:e1308. [PMID: 33085843 PMCID: PMC7941436 DOI: 10.1002/cnr2.1308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND CDK4/6 inhibitors have shown promising results for treating advanced breast cancer (ABC) and are routinely used in Singapore. In view of their high costs, it is important to assess their relative value compared to existing standards of care in the local setting. AIMS This study evaluates the cost-effectiveness of adding ribociclib to goserelin and a nonsteroidal aromatase inhibitor or tamoxifen as initial therapy for premenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) ABC in Singapore. METHODS A partitioned survival model with four health states (progression-free on first-line treatment, progression-free on second-line treatment, progressed disease, and death) was developed from a healthcare system perspective over a 10-year time horizon. Key clinical inputs were derived from the MONALEESA-7 trial, and survival curves were extrapolated beyond the trial period. Health state utilities were derived from the literature and direct medical costs were obtained from local public healthcare institutions. A discount rate of 3% was applied to both costs and outcomes. One-way deterministic and probabilistic sensitivity analyses were conducted to explore uncertainties. RESULTS The base-case analysis resulted in an incremental cost-effectiveness ratio (ICER) of SGD197, 667 per quality-adjusted life-year. Sensitivity analyses showed that the ICER was sensitive to the survival parametric distribution, ribociclib price, time horizon, and utility weights used. Even when these were varied, ICERs remained high and not cost-effective in the local context. CONCLUSION At its current price, adding ribociclib to endocrine therapy is unlikely to be cost-effective in Singapore for HR+, HER2- ABC. Results from this study are useful to inform future funding decisions for CDK4/6 inhibitors alongside other factors including clinical effectiveness, safety, and budget impact considerations.
Collapse
Affiliation(s)
- Lydia Loke
- Agency for Care Effectiveness (ACE), Ministry of Health, Singapore
| | - Soo-Chin Lee
- National University Cancer Institute (NCIS), Singapore
| | - Fiona Pearce
- Agency for Care Effectiveness (ACE), Ministry of Health, Singapore
| | - Kwong Ng
- Agency for Care Effectiveness (ACE), Ministry of Health, Singapore
| | | |
Collapse
|
|
7
|
Davie A, Carter GC, Rider A, Pike J, Lewis K, Bailey A, Price GL, Ringeisen F, Pivot X. Real-world patient-reported outcomes of women receiving initial endocrine-based therapy for HR+/HER2- advanced breast cancer in five European countries. BMC Cancer 2020; 20:855. [PMID: 32894087 PMCID: PMC7487722 DOI: 10.1186/s12885-020-07294-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/11/2020] [Indexed: 12/24/2022] Open
Abstract
Background Endocrine therapy (ET)-based regimens are the mainstay of treatment for patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−) advanced breast cancer. With the introduction of new treatment classes, it is important to examine patient symptoms and health-related quality of life (HRQoL) at the start of this changing therapeutic landscape. This real-world study describes the patient-reported outcomes (PROs) of women with HR+/HER2− advanced breast cancer receiving ET-based regimens who were naïve to systemic treatment in the advanced setting across five European countries (EU5). Methods Data were collected between March and July 2017 from surveyed oncologists and their patients at a single time point using the multinational Adelphi Advanced Breast Cancer Disease Specific Programme™. Patients completed PRO questionnaires on HRQoL (EORTC QLQ-C30), pain severity and interference, and work and activity impairment. A multiple linear regression model explored factors associated with HRQoL. Results Across EU5, 226 physicians provided data on 781 women with HR+/HER2− advanced breast cancer taking their first ET-based regimen for advanced disease, of whom 252 provided PRO data. This subset had a mean age of 67.1 years, 94% were postmenopausal, 89% were diagnosed with advanced breast cancer at initial presentation, 79% had stage IV disease (66% of these patients had bone metastases and 38% had visceral metastases, including 18% with liver metastases) and 77% were on endocrine-only therapy as their initial treatment for advanced disease. The mean EORTC QLQ-C30 global health score (50.9) was worse than the reference value for patients with advanced breast cancer (60.2). Fatigue, pain, and insomnia were the most severe symptoms, and mean functioning scores were also worse than reference values. “Worst pain” and “pain interference” were moderate/severe for 42 and 80% of patients. Mean activity impairment was 44%, and greater activity impairment was associated with poorer HRQoL. Conclusions Despite receiving first-line ET-based regimens for advanced disease, these women had a poor HRQoL and high levels of symptoms, pain, pain interference and activity impairment. New treatments that maintain a stable disease state and reduce activity impairment may have a positive effect on the HRQoL of those living with advanced breast cancer.
Collapse
Affiliation(s)
- Alison Davie
- Eli Lilly and Co Ltd, Windlesham, Surrey, GU20 6PH, UK.
| | | | - Alex Rider
- Adelphi Real World, Bollington, Macclesfield, Cheshire, SK10 5JB, UK
| | - James Pike
- Adelphi Real World, Bollington, Macclesfield, Cheshire, SK10 5JB, UK
| | - Katie Lewis
- Adelphi Real World, Bollington, Macclesfield, Cheshire, SK10 5JB, UK
| | - Abigail Bailey
- Adelphi Real World, Bollington, Macclesfield, Cheshire, SK10 5JB, UK
| | | | | | | |
Collapse
|
|
8
|
Quality of life in a real-world cohort of advanced breast cancer patients: a study of the SONABRE Registry. Qual Life Res 2020; 29:3363-3374. [PMID: 32816222 PMCID: PMC7686224 DOI: 10.1007/s11136-020-02604-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2020] [Indexed: 01/19/2023]
Abstract
Purpose We aimed to evaluate quality of life (QoL) using the European Quality of Life Five-Dimensions questionnaire (EQ-5D-3L) in a real-world cohort of Dutch advanced breast cancer (ABC) patients. Secondary, we reported differences in QoL between subgroups of patients based on age, comorbidity, tumor-, and treatment characteristics, and assessed the association of duration of metastatic disease and time to death with QoL. Methods ABC patients who attended the outpatient clinic between October 2010 and May 2011 were asked to fill out the EQ-5D-3L questionnaire. Patient-, disease-, and treatment characteristics were obtained from the medical files. Health-utility scores were calculated. Subgroups were described and compared for utility scores by parametric and non-parametric methods. Results A total of 92 patients were included with a median utility score of 0.691 (Interquartile range [IQR] 0.244). Patients ≥ 65 years had significantly worse median utility scores than younger patients; 0.638 versus 0.743, respectively (p = 0.017). Moreover, scores were significantly worse for patients with versus those without comorbidity (medians 0.620 versus 0.725, p = 0.005). Utility scores did not significantly differ between subgroups of tumor type, type of systemic treatment, number of previous palliative treatment(s), or number or location of metastatic site(s). The remaining survival was correlated with utility scores (correlation coefficient (r) = 0.260, p = 0.0252), especially in the subgroup < 65 years (r = 0.340, p = 0.0169), whereas there was no significant correlation with time since metastatic diagnosis (r = − 0.106, p = 0.3136). Conclusion Within this real-world cross-sectional study, QoL was significantly associated with age, comorbidity, and remaining survival duration. The observation of a lower QoL in ABC patients, possibly indicating the last period of life, may assist clinical decision-making on timing of cessation of systemic antitumor therapy.
Collapse
|
|
9
|
He G, Ma Y, Zhou H, Sun S, Wang X, Qian H, Xu Y, Miao Z, Zha Z. Mesoporous NiS2 nanospheres as a hydrophobic anticancer drug delivery vehicle for synergistic photothermal–chemotherapy. J Mater Chem B 2019; 7:143-149. [DOI: 10.1039/c8tb02473a] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Monodispersed mesoporous NiS2 nanospheres (mNiS2 NSs) have been successfully developed here through a facile solvothermal method to act as a hydrophobic drug delivery vehicle for synergistic photothermal–chemo treatment of cancer.
Collapse
Affiliation(s)
- Gang He
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Yan Ma
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Hu Zhou
- The First Affiliated Hospital of University of Science and Technology of China
- Anhui Provincial Cancer Hospital
- Hefei
- P. R. China
| | - Siyuan Sun
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Xianwen Wang
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Haisheng Qian
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Yan Xu
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Zhaohua Miao
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| | - Zhengbao Zha
- School of Food and Biological Engineering
- Hefei University of Technology
- Hefei
- P. R. China
| |
Collapse
|