Induction Therapy Improves Quality of Life Scores for Patients Receiving RT for Squamous NSCLC

Induction therapy with nab-paclitaxel/carboplatin improved or maintained quality of life (QoL) for patients undergoing radiotherapy.
Induction therapy with nab-paclitaxel/carboplatin improved or maintained quality of life (QoL) for patients undergoing radiotherapy.

Induction therapy with nab-paclitaxel/carboplatin improved or maintained quality of life (QoL) for patients undergoing radiotherapy for squamous cell carcinoma (SCC) non-small cell lung cancer (NSCLC), according to a poster presented at the 2016 ASCO Quality Care Symposium.1

Because the correlation of radiologic response and patient-reported outcomes in advanced NSCLC remains underreported, an interim analysis to evaluate QoL by response (RECIST v1.1) in patients participating in the ABOUND.sqm study (ClinicalTrials.gov NCT02027428) was conducted. Patients with advanced SCC NSCLC who received induction therapy as part of the ABOUND.sqm study were asked to complete predefined patient-reported outcomes instruments. 

Induction therapy in the ongoing phase III ABOUND.sqm study consisted of nab-paclitaxel 100 mg/m2 on days 1, 8, and 15, and carboplatin AUC 6 mg•min/mL on day 1 of each 21-day cycle; patients underwent 4 cycles. Patients whose disease did not progress were randomly assigned 2:1 to receive maintenance nab-paclitaxel 100 mg/m2 on day 1 and 8 of each 21-day cycle plus best supportive care (BSC) or BSC alone until disease progression.

For the interim analysis, QoL was assessed with the Lung Cancer Symptom Scale (LCSS) and the EQ-5D-5L on day 1 of each cycle. Patients with a radiological complete response/partial response were considered responders (57% of evaluable patients). As this is an ongoing study, the preplanned analysis included QoL and tumor response data reported up to the cutoff date. 

Baseline characteristics on the instruments were similar for responders (n = 73) and nonresponders (n = 55). More than 80% of patients completed baseline patient-reported outcomes assessment plus 1 or more postbaseline assessments.

Average total score and symptom burden index on LCSS improved during induction chemotherapy. A higher percentage of responders had clinically meaningful improvements (10 mm or greater [VAS]) from baseline in composite LCSS cough, shortness of breath, and hemoptysis compared with nonresponders (56% vs 38%). Of patients reporting baseline EQ-5D-5L dimension problem(s), a higher percentage of responders reported complete resolution at least once during treatment, compared with nonresponders.

The researchers conclude that induction therapy with nab-paclitaxel/carboplatin maintained or improved QoL for patients with advanced SCC NSCLC in both responders and nonresponders. However, greater improvements were reported on LCSS and EQ-5D-5L among those patients with radiological response.

REFERENCE

1. Langer CJ, Hirsh V, Amiri K, et al. Quality of life (QoL) by response: an interim analysis of patients (pts) with squamous (SCC) NSCLC treated with nab-paclitaxel/carboplatin (nab-P/C) induction therapy in the phase III ABOUND.sqm study. J Clin Oncol. 2016;34(suppl7S):Abstract 63. 

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