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Published in: Journal of Cancer Research and Clinical Oncology 12/2005

01-12-2005 | Original Paper

Impact of gefitinib (‘Iressa’) treatment on the quality of life of patients with advanced non-small-cell lung cancer

Authors: Alain Gelibter, Anna Ceribelli, Camillo F. Pollera, Michele Milella, Luca Moscetti, Isabella Sperduti, Francesco Cognetti

Published in: Journal of Cancer Research and Clinical Oncology | Issue 12/2005

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Abstract

Purpose: Patients with advanced non-small-cell lung cancer (NSCLC) have a short life expectancy; therefore, in addition to increasing their survival, improving their quality of life (QoL) is also an important treatment goal. Methods: We evaluated the QoL of patients with advanced NSCLC who were unfit to receive chemotherapy, failed to respond or progress following prior chemotherapy, who received subsequent treatment with gefitinib (‘Iressa’) on a compassionate use basis, using a standard QoL questionnaire, (EORTC) QLQ-C30 and the related lung cancer-specific module QLQ-LC13. Results: Analysis of the functional scales showed a trend towards improvement for role, emotional and cognitive scales, while a substantial stability was seen for general QoL scale. Analysis of the symptoms scales of QLQ-C30, showed a trend towards improvement for fatigue, dyspnoea, insomnia, and constipation, after one month of therapy. Fifty-six of the 57 patients were considered evaluable for response. One patient evidenced a partial response (patient is still on response), 29 patients had stable disease for a median duration of 5months (range 4–7 months), and 26 patients progressed. Conclusions: After treatment with Gefitinib, we observed maintenance of QoL in a group of patients with poor prognosis that would be expected to have a worsening QoL. Furthermore important symptoms like dyspnoea fatigue and pain in other parts, that usually afflict patients with NSCLC, showed a trend toward improvement after only one month of therapy.
Literature
go back to reference Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JCJ, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JCJ, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRef
go back to reference American Society of Clinical Oncology (1996) Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 14:671–679 American Society of Clinical Oncology (1996) Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 14:671–679
go back to reference Armstrong BG, Sloan M (1989) Ordinal regression models for epidemiologic data. Am J Epidemiol 129:191–204PubMed Armstrong BG, Sloan M (1989) Ordinal regression models for epidemiologic data. Am J Epidemiol 129:191–204PubMed
go back to reference Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M (1994) The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer 30A:635–642CrossRef Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M (1994) The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer 30A:635–642CrossRef
go back to reference Berridge DM, Whitehead J (1991) Analysis of failure time data with ordinal categories of response. Stat Med 10:1703–1710PubMedCrossRef Berridge DM, Whitehead J (1991) Analysis of failure time data with ordinal categories of response. Stat Med 10:1703–1710PubMedCrossRef
go back to reference Dancey J, Shepherd FA, Gralla RJ, Kim YS (2004) Quality of life assessment of second-line docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy: results of a prospective, randomized phase III trial. Lung Cancer 43:183–194CrossRefPubMed Dancey J, Shepherd FA, Gralla RJ, Kim YS (2004) Quality of life assessment of second-line docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy: results of a prospective, randomized phase III trial. Lung Cancer 43:183–194CrossRefPubMed
go back to reference Douillard J-Y, Giaccone G, Horai T, Noda K, Vansteenkiste JF, Takata I, Gatzemeier U, Fukuoka M, Macleod A, Feyereislova A, Averbuch S, Nogi Y, Heyes A, Baselga J (2002) Improvement in disease-related symptoms and quality of life in patients with advanced non-small-cell lung cancer (NSCLC) treated with ZD1839 (’Iressa’) (IDEAL 1). Proc Am Soc Clin Oncol 21:299a (abs 1195) Douillard J-Y, Giaccone G, Horai T, Noda K, Vansteenkiste JF, Takata I, Gatzemeier U, Fukuoka M, Macleod A, Feyereislova A, Averbuch S, Nogi Y, Heyes A, Baselga J (2002) Improvement in disease-related symptoms and quality of life in patients with advanced non-small-cell lung cancer (NSCLC) treated with ZD1839 (’Iressa’) (IDEAL 1). Proc Am Soc Clin Oncol 21:299a (abs 1195)
go back to reference Fossella FV, DeVore R, Kerr RN, Crawford J, Natale RR, Dunphy F, Kalman L, Miller V, Lee JS, Moore M, Gandara D, Karp D, Vokes E, Kris M, Kim Y, Gamza F, Hammershaimb L (2000) The TAX 320 Non-Small Cell Lung Cancer Study Group: randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. J Clin Oncol 18:2354–2362PubMed Fossella FV, DeVore R, Kerr RN, Crawford J, Natale RR, Dunphy F, Kalman L, Miller V, Lee JS, Moore M, Gandara D, Karp D, Vokes E, Kris M, Kim Y, Gamza F, Hammershaimb L (2000) The TAX 320 Non-Small Cell Lung Cancer Study Group: randomized phase III trial of docetaxel versus vinorelbine or ifosfamide in patients with advanced non-small-cell lung cancer previously treated with platinum-containing chemotherapy regimens. J Clin Oncol 18:2354–2362PubMed
go back to reference Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard J-Y, Nishiwaki Y, Vansteenkiste J, Kudoh S, Rischin D, Eek R, Horai T, Noda K, Takata I, Smit E, Averbuch S, Macleod A, Feyereislova A, Dong R-P, Baselga J (2003) Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer. J Clin Oncol 21:2237–2246CrossRefPubMed Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard J-Y, Nishiwaki Y, Vansteenkiste J, Kudoh S, Rischin D, Eek R, Horai T, Noda K, Takata I, Smit E, Averbuch S, Macleod A, Feyereislova A, Dong R-P, Baselga J (2003) Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer. J Clin Oncol 21:2237–2246CrossRefPubMed
go back to reference Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observation. J Am Stat Assoc 53:457–481CrossRef Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observation. J Am Stat Assoc 53:457–481CrossRef
go back to reference Kris MG, Natale RB, Herbst RS, Lynch TJ Jr, Prager D, Belani CP, Schiller JH, Kelly K, Spiridonidis H, Sandler A, Albain KS, Cella D, Wolf MK, Averbuch SD, Ochs JJ, Kay AC (2003) Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer. A randomized trial. JAMA 290:2149–2158CrossRefPubMed Kris MG, Natale RB, Herbst RS, Lynch TJ Jr, Prager D, Belani CP, Schiller JH, Kelly K, Spiridonidis H, Sandler A, Albain KS, Cella D, Wolf MK, Averbuch SD, Ochs JJ, Kay AC (2003) Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer. A randomized trial. JAMA 290:2149–2158CrossRefPubMed
go back to reference Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR (2001) Quality of life in lung cancer patients as an important prognostic factor. Lung Cancer 31:233–240CrossRefPubMed Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR (2001) Quality of life in lung cancer patients as an important prognostic factor. Lung Cancer 31:233–240CrossRefPubMed
go back to reference Natale RB, Zaretsky SL (2002) ZD1839 (IressaTM): what’s in it for the patient?. Oncologist 7(Suppl 4):25–30PubMedCrossRef Natale RB, Zaretsky SL (2002) ZD1839 (IressaTM): what’s in it for the patient?. Oncologist 7(Suppl 4):25–30PubMedCrossRef
go back to reference Natale R, Skarin A, Maddox A, Hammond L, Thomas R, Gandara D, Gerstein H, Panella T, Cole J, Jahanzeb M, Kash J, Hamm J, Langer C, Saleh M, Stella P, Heyes A, Helms L, Ochs J, Averbuch S, Wolf M, Kay A (2002) Improvement in symptoms and quality of life for advanced non-small-cell lung cancer patients receiving ZD1839 (’Iressa’) in IDEAL 2. Proc Am Soc Clin Oncol 21:292a (abs 1167) Natale R, Skarin A, Maddox A, Hammond L, Thomas R, Gandara D, Gerstein H, Panella T, Cole J, Jahanzeb M, Kash J, Hamm J, Langer C, Saleh M, Stella P, Heyes A, Helms L, Ochs J, Averbuch S, Wolf M, Kay A (2002) Improvement in symptoms and quality of life for advanced non-small-cell lung cancer patients receiving ZD1839 (’Iressa’) in IDEAL 2. Proc Am Soc Clin Oncol 21:292a (abs 1167)
go back to reference Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16:139–144PubMed Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16:139–144PubMed
go back to reference Rowinsky EK (2001) EGFR-targeted cancer therapies: Is there a need to reconsider clinical trial design? A discussion of how, and why, clinical trial design should be altered for the clinical evaluation of EGRF-targeted cancer therapies. Signal 2:4–12CrossRef Rowinsky EK (2001) EGFR-targeted cancer therapies: Is there a need to reconsider clinical trial design? A discussion of how, and why, clinical trial design should be altered for the clinical evaluation of EGRF-targeted cancer therapies. Signal 2:4–12CrossRef
go back to reference Shepherd FA, Dancey J, Ramlau R, Mattson K, Gralla R, O’Rourke M, Levitan N, Gressot L, Vincent M, Burkes R, Coughlin S, Kim Y, Berille J (2000) Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 18:2095–2103PubMed Shepherd FA, Dancey J, Ramlau R, Mattson K, Gralla R, O’Rourke M, Levitan N, Gressot L, Vincent M, Burkes R, Coughlin S, Kim Y, Berille J (2000) Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 18:2095–2103PubMed
go back to reference Silvestri G, Pritchard R, Welch HG (1998) Preferences for chemotherapy in patients with advanced non-small cell lung cancer: descriptive study based on scripted interviews. BMJ 317:771–775PubMed Silvestri G, Pritchard R, Welch HG (1998) Preferences for chemotherapy in patients with advanced non-small cell lung cancer: descriptive study based on scripted interviews. BMJ 317:771–775PubMed
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92(3):205–216CrossRefPubMed Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92(3):205–216CrossRefPubMed
go back to reference WHO (1979) Handbook for reporting results in cancer treatment. World Health Organization, Geneva WHO (1979) Handbook for reporting results in cancer treatment. World Health Organization, Geneva
Metadata
Title
Impact of gefitinib (‘Iressa’) treatment on the quality of life of patients with advanced non-small-cell lung cancer
Authors
Alain Gelibter
Anna Ceribelli
Camillo F. Pollera
Michele Milella
Luca Moscetti
Isabella Sperduti
Francesco Cognetti
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Journal of Cancer Research and Clinical Oncology / Issue 12/2005
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-005-0029-9

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