Translation to Other Cancers

Though Dr Hui and Dr Alam’s studies add to the body of evidence supporting the prognostic value of QOL assessments, it remains unclear whether QOL can predict PFS and OS across cancer types.

“Strictly speaking, we can only apply the study findings to patients similar to those in our study,” Dr Hui said. “However, the greater literature has generally found similar findings in patients with other cancer types. So the overall picture suggests that baseline health-related QOL is associated with survival, particularly strongly for overall survival and weakly [or] moderately for progression-free survival.”

Continue Reading

Dr Alam said his team’s findings could likely translate to other cancers as long as those malignancies are typically asymptomatic.  

“These findings are likely applicable to a wide variety of cancers where the cancer is not causing physical symptoms,” Dr Alam said. “In cancers causing symptoms, it’s much harder to tell how treating the cancer may improve physical symptoms and creates an additional layer of complexity.”

Implementing QOL Assessments

Dr Hui said that one of the take-home messages of his study is that researchers should consider routinely incorporating QOL assessments in clinical trials. In fact, he and his colleagues noted that a limitation of their study is how few clinical trials actually employ QOL assessments and how little data there is to evaluate.

Dr Hui said one reason for this gap in data is likely concern that asking patients to fill out a QOL questionnaire would be an added burden on the patient. Another reason is that not enough clinicians are familiar with interpreting the answers to such questionnaires even when patients do fill them out. 

Dr Alam agreed that more widely implementing QOL assessments will be beneficial only if it doesn’t further burden patients and clinicians. He suggested that improved electronic medical records might help streamline the process.

Disclosures: Dr Hui disclosed research funding from Helsinn Healthcare. Dr Alam reported having no disclosures.

References

  1. Ediebah DE, Quinten C, Coens C, et al. Quality of life as a prognostic indicator of survival: A pooled analysis of individual patient data from Canadian cancer trials group clinical trials. Cancer. 2018;124(16):3409-3416. doi:10.1002/cncr.31556
  2. Lehto US, Ojanen M, Väkevä A, Dyba T, Aromaa A, Kellokumpu-Lehtinen P. Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer. Qual Life Res. 2019;28(3):677-686. doi:10.1007/s11136-018-2069-z
  3. Fernando HC, Landreneau RJ, Mandrekar SJ, et al. Analysis of longitudinal quality-of-life data in high-risk operable patients with lung cancer: Results from the ACOSOG Z4032 (Alliance) multicenter randomized trial. J Thorac Cardiovasc Surg. 2015;149(3):718-25. doi: 10.1016/j.jtcvs.2014.11.003
  4. Takada K, Kashiwagi S, Asano Y, et al. Prognostic value of quality of life in endocrine therapy for elderly patients with breast cancer: A retrospective study. Anticancer Res. 2019;39(6):2941-2950. doi:10.21873/anticanres.13424
  5. Cella D, Cappelleri JC, Bushmakin A, et al. Quality of life predicts progression-free survival in patients with metastatic renal cell carcinoma treated with sunitinib versus interferon alfa. J Oncol Pract. 2009;5(2):66-70. doi:10.1200/JOP.0922004
  6. Alam R, Patel HD, Su ZT, et al. Self‐reported quality of life as a predictor of mortality in renal cell carcinoma. Cancer. Published online October 5, 2021. doi:10.1002/cncr.33956
  7. Hui E, Darke AK, Guthrie KA, et al. Association between health-related quality of life and progression-free survival in patients with advanced cancer: A secondary analysis of SWOG clinical trials. JCO Oncol Pract. Published online October 4, 2021. doi:10.1200/OP.21.00407

Topics:

General Oncology Kidney Cancer Lung Cancer Prostate Cancer Renal Cell Carcinoma Side-Effect Management