Patient-reported outcomes and health-related quality of life for cetuximab versus bevacizumab in metastatic colorectal cancer: a prospective cohort study

摘要

PurposeUncertainty exists regarding Patient-Reported Outcomes (PROs) and Health-Related Quality of Life (HRQoL) of patients with metastatic colorectal cancer (mCRC) treated with cetuximab or bevacizumab. We conducted a prospective cohort study comparing PROs and HRQoL from both therapies.MethodsWe assessed PROs and HRQoL from patients treated with cetuximab or bevacizumab using QLQ-C30 and QLQ-CR29 questionnaires at three sequential time points, including baseline. Global Health Status (GHS), functional and symptom scales, and Overall Treatment Utility (derived from clinical and patient-reported outcomes) were compared for the two treatment strategies.ResultsBetween January 2017 and April 2018, 44 patients were allocated to cetuximab (n=19) or bevacizumab (n=25). Except for RAS mutation status, patient baseline characteristics were generally well balanced across treatment groups. A higher proportion of patients experienced a deterioration in GHS (10%) in cetuximab arm-53.8% (95% CI 25.1-80.8%) at 6weeks and 66.7% (95% CI 29.9-92.5%) at 12weekscomparing to bevacizumab cohort: 18.2% (95% CI 5.2-40.3%) at 6weeks and 12.5% (95% CI:1.6-38.3%) at 12weeks. Treatment utility rates at 6 and 12weeks were, respectively, 88.6% and 69.8% for bevacizumab, compared to 49% and 19.1% for cetuximab (p=0.004), a difference confirmed in subset analyses.ConclusionsIn patients with mCRC, cetuximab-containing regimens led to a progressive negative impact on PROs and global HRQoL, when compared to baseline and bevacizumab. Future research is needed to confirm these results. Our findings demonstrate the value of PROs when assessing comparative effectiveness of different treatment regimens.