Effect of early tumor response on the health-related quality of life among patients on second-line chemotherapy for advanced gastric cancer in the ABSOLUTE trial.

Fujitani, Kazumasa; Shitara, Kohei; Takashima, Atsuo; Koeda, Keisuke; Hara, Hiroki; Nakayama, Norisuke; Hironaka, Shuichi; Nishikawa, Kazuhiro; Kimura, Yutaka; Amagai, Kenji; Hosaka, Hisashi; Komatsu, Yoshito; Shimada, Ken; Kawabata, Ryohei; Ohdan, Hideki; Kodera, Yasuhiro; Nakamura, Masato; Nakajima, Takako Eguchi; Miyata, Yoshinori; Moriwaki, Toshikazu; Kusumoto, Tetsuya; Nishikawa, Kazuo; Ogata, Kazuhiro; Shimura, Masashi; Morita, Satoshi; Koizumi, Wasaburo

BACKGROUND This study evaluated the association between early tumor response at 8 weeks, previously reported as a positive outcome prognosticator, and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients enrolled in the ABSOLUTE trial. METHODS HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D) utility index score in patients with complete response (CR) + partial response (PR) and progressive disease (PD) at 8 weeks, and time-to-deterioration (TtD) of the EQ-5D score, with the preset minimally important difference (MID) of 0.05, was compared between these populations. Among the enrolled patients, 143 and 160 patients were assessable in weekly solvent-based paclitaxel (Sb-PTX) arm and weekly nanoparticle albumin-bound paclitaxel (nab-PTX) arm, respectively. RESULTS Changes of the EQ-5D score from baseline to 8 weeks in the nab-PTX arm were 0.0009 and - 0.1229 in CR + PR and PD patients, respectively; the corresponding values for the Sb-PTX arm were - 0.0019 and - 0.1549. For both treatments, changes of the EQ-5D score from baseline at 8 weeks were significantly larger in patients with PD than in those with CR + PR. The median TtD was 3.9 and 2.2 months in patients with CR + PR and PD, respectively, for nab-PTX [hazard ratio (HR) = 0.595, 95% confidence interval (CI) 0.358-0.989]. For Sb-PTX, the corresponding values were 4.7 and 2.0 months (HR = 0.494, 95% CI 0.291-0.841). CONCLUSIONS Early tumor shrinkage was associated with maintained HRQOL in AGC patients on the second-line chemotherapy with taxanes.