Patient-reported outcomes at discontinuation of anti-angiogenesis therapy in the randomized trial of chemotherapy with bevacizumab for advanced cervical cancer: An NRG Oncology Group study

Dana Chase, Helen Q. Huang, Bradley J. Monk, Lois Michelle Ramondetta, Richard T. Penson, Karen Gil, Lisa M. Landrum, Mario Leitao, Ana Oaknin, Warner K. Huh, Heather L. Pulaski, Katina Robison, Saketh R. Guntupalli, Debra Richardson, Ritu Salani, Michael W. Sill, Lari B. Wenzel, Krishnansu Sujata Tewari

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: To describe patient-reported outcomes and toxicities at time of treatment discontinuation secondary to progression or toxicities in advanced/recurrent cervical cancer patients receiving chemotherapy with bevacizumab. Methods: Summarize toxicity, grade, and health-related quality of life within 1 month of treatment discontinuation for women receiving chemotherapy with bevacizumab in GOG240. Results: Of the 227 patients who received chemotherapy with bevacizumab, 148 discontinued study protocol treatment (90 for disease progression and 58 for toxicity). The median survival time from treatment discontinuation to death was 7.9 months (95% CI 5.0 to 9.0) for those who progressed versus 12.1 months (95% CI 8.9 to 23.2) for those who discontinued therapy due to toxicities. The most common grade 3 or higher toxicities included hematologic, gastrointestinal, and pain. Some 57% (84/148) of patients completed quality of life assessment within 1 month of treatment discontinuation. Those patients who discontinued treatment due to progression had a mean decline in the FACT-Cx TOI of 3.2 points versus 2.2 in patients who discontinued therapy due to toxicity. This was a 9.9 point greater decline in the FACT-Cx TOI scores than those who discontinued treatment due to progression (95% CI 2.8 to 17.0, p=0.007). The decline in quality of life was due to worsening physical and functional well-being. Those who discontinued treatment due to toxicities had worse neurotoxicity and pain. Discussion: Patients who discontinued chemotherapy with bevacizumab for toxicity experienced longer post-protocol survival but significantly greater declination in quality of life than those with progression. Future trial design should include supportive care interventions that optimize physiologic function and performance status for salvage therapies.

Original languageEnglish (US)
Article number000869
JournalInternational Journal of Gynecological Cancer
DOIs
StateAccepted/In press - 2020

Keywords

  • cervical cancer
  • gynecology
  • quality of life (PRO)/palliative care

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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