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Pre-treatment global quality of health predicts progression free survival in metastatic kidney cancer patients treated with sorafenib or sunitinib

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Abstract

Purpose

Our goal was to prospectively evaluate self-reported quality-of-life (QoL) during second-line therapy in 51 consecutive patients with cytokine-refractory kidney cancer treated with sorafenib or sunitinib.

Methods

QoL was assessed by the EORTC QoL questionnaire QLQ-C30 at baseline and at weeks 4, 6, 10, 12 and 16.

Results

Global QoL deteriorated significantly during the first 4 weeks of treatment (P < 0.0001). Patients experienced a reduction of their role, cognitive, and social function (all P < 0.0001). In addition, fatigue (P < 0.0001), nausea/vomiting (P = 0.003), and pain (P < 0.0001) as well as dyspnoea (P < 0.0001), insomnia (P = 0.026), appetite loss (P = 0.013), and diarrhoea (P < 0.0001) increased significantly. After 16 weeks, fatigue (P < 0.0001), pain (P = 0.015), appetite loss (P = 0.002) and diarrhoea (P = 0.038) were still influenced by the therapy, while all functional scales recovered. Global QoL at baseline was predictive of overall response (P = 0.006) and progression free survival (PFS) (P < 0.0001). A better physical function at baseline, a better ECOG performance status, and a low risk profile according to MSKCC risk groups correlated with a longer PFS (all P < 0.0001). No significant differences regarding QoL were found between sorafenib and sunitinib during the study period.

Conclusions

Second-line therapy with sorafenib or sunitinib does not adversely affect patients global QoL after 16 weeks of treatment. Evaluation of baseline QoL can help to further stratify patients into risk groups predicting overall response and PFS.

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Authors and Affiliations

  1. Department of Urology, University of Münster, Albert-Schweitzer Str. 33, 48149, Munster, Germany

    Edwin Herrmann, Stefan Bierer, Thomas Köpke, Lothar Hertle & Christian Wülfing

  2. Department of Medical Informatics and Biomathematics, University of Münster, Domagkstraße 9, 48149, Munster, Germany

    Joachim Gerss

  3. Department of Urology, University of Mannheim, Theodor-Kutzer-Ufer 1-3, 48167, Mannheim, Germany

    Christian Bolenz

Authors
  1. Edwin Herrmann
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  2. Joachim Gerss
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  3. Stefan Bierer
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  4. Thomas Köpke
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  5. Christian Bolenz
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  6. Lothar Hertle
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  7. Christian Wülfing
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Corresponding author

Correspondence to Edwin Herrmann.

Additional information

Edwin Herrmann and Joachim Gerss contributed equally to this work.

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Herrmann, E., Gerss, J., Bierer, S. et al. Pre-treatment global quality of health predicts progression free survival in metastatic kidney cancer patients treated with sorafenib or sunitinib. J Cancer Res Clin Oncol 135, 61–67 (2009). https://doi.org/10.1007/s00432-008-0438-7

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  • DOI: https://doi.org/10.1007/s00432-008-0438-7

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