1
|
Johnson PC, Bailey A, Ma Q, Milloy N, Butcher J, Sanderson I, Weatherby S, Meadows R, Quek RGW. Real-world evaluation of health-related quality of life in patients with diffuse large B-cell lymphoma based on a multinational survey. Front Oncol 2024; 14:1402992. [PMID: 38978741 PMCID: PMC11228594 DOI: 10.3389/fonc.2024.1402992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/27/2024] [Indexed: 07/10/2024] Open
Abstract
Background Real-world health-related quality of life (HRQoL) data in patients with diffuse large B-cell lymphoma (DLBCL) are scarce. This study is to compare patient-reported outcomes in patients with DLBCL across therapy lines and countries. Methods Data were derived from the Adelphi DLBCL Disease Specific Programme™ from January 2021 to May 2021, a survey of physicians and their DLBCL patients in France, Germany, Italy, Spain, United Kingdom (UK), and the United States (US). Results Overall, analysis was conducted on 441 patients with DLBCL across Europe and the US (mean age 64.6 years, 64% male); 68% had an Ann Arbor stage III and 69% had an Eastern Cooperative Oncology Group Performance Status of 0 to 1. The mean overall GHS/QoL was 54.1; patients on their 3L+ therapy had a lower mean GHS/QoL compared with patients on 1L/2L (P = 0.0033). Further to this, mean EQ-5D-5L utility score was reduced from 0.73 for patients on 1L therapy to 0.66 for patients on 3L+ therapies (P = 0.0149). Mean percentages of impairment while working and overall work impairment were lower for patients receiving 3L+ therapy (12.5% and 17.7%; respectively) than those on 1L therapy (35.6% and 33.8%; respectively). When comparing region, patients in the US had significantly better scores for all functioning and symptomatic scales (per EORTC QLQ-C30) and work impairment (per WPAI) vs. patients with DLBCL in Europe. WPAI scores indicate that the overall activity impairment in the US was 36.6% and in Europe ranged from 42.4% in the UK to 54.9% in Germany. Mean EQ-5D-5L utility score for the US was 0.80, compared to 0.60 - 0.80 across the countries in Europe. Regression analysis showed patients who relapsed after more than one year of treatment were associated with better patient reported outcomes than those who relapse after less than one year. Conclusion Patient-reported outcomes of DLBCL patients remain poor and patients continue to experience considerable morbidity.
Collapse
Affiliation(s)
- P. Connor Johnson
- Cancer Center, Massachusetts General Hospital, Boston, MA, United States
| | | | - Qiufei Ma
- Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, NY, United States
| | - Neil Milloy
- Adelphi Real World, Bollington, United Kingdom
| | | | | | | | | | - Ruben G. W. Quek
- Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, NY, United States
| |
Collapse
|
2
|
Kubuschok B, Otremba B, Welslau M, Topaly J, Wolff T, Lenz G, Grau M, Bittencourt da Silva L, Brückmann I, Foierl T. Quality of life assessment in diffuse large B-cell lymphoma (DLBCL) in REFLECT: a prospective, non-interventional, multicenter, German study, assessing Sandoz rituximab in combination with CHOP. Ann Hematol 2024:10.1007/s00277-024-05850-5. [PMID: 38900302 DOI: 10.1007/s00277-024-05850-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
Health-related quality of life (HRQoL) data are important indicators of health status in patients with lymphoma. The objective of this analysis was to assess the impact of treatment with Sandoz rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) on HRQoL in treatment-naïve adult patients with diffuse large B-cell lymphoma (DLBCL) included in the prospective, real-world REFLECT study. REFLECT is the first prospective study to assess HRQoL in patients with DLBCL treated with a rituximab biosimilar. HRQoL was assessed via the patient-reported European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire at baseline, mid-treatment (month 3), end of treatment (month 6), and follow-up (months 9 and 12). Subgroup analyses were performed to evaluate the influence of baseline characteristics on HRQoL, and associations between baseline HRQoL and treatment response. HRQoL was assessed in 169 patients. Mean global health status score remained stable from baseline (54.8) to mid-treatment (month 3; 54.7), before steadily improving through to end of treatment (month 6; 61.4), and follow-up month 9 (64.9) and month 12 (68.8). Similar trends were observed across most functional and symptom subscales. Higher cognitive, physical, or role functioning, and less appetite loss, diarrhea, fatigue, or pain at baseline, were all associated with an improved likelihood of reaching a complete versus partial response at the end of treatment. Overall, these findings confirm the HRQoL benefits of R-CHOP therapy in treatment-naïve adult patients with DLBCL, and suggest that baseline HRQoL may be predictive of treatment response.
Collapse
Affiliation(s)
- Boris Kubuschok
- Department of Internal Medicine II (Hematology/Oncology) and Comprehensive Cancer Center Augsburg, CCC Alliance WERA and Bavarian Cancer Research Center (BZKF), Universitätsklinikum Augsburg, Augsburg, Germany.
| | | | - Manfred Welslau
- Comprehensive Cancer Center Mainfranken, Onkologie Aschaffenburg, Germany and Comprehensive Cancer Center Mainfranken, CCC Alliance WERA and BZKF, Würzburg, Germany
| | | | | | - Georg Lenz
- Department of Medicine A for Hematology, Oncology and Pneumology, Universitätsklinikum Münster, Münster, Germany
| | - Michael Grau
- Department of Medicine A for Hematology, Oncology and Pneumology, Universitätsklinikum Münster, Münster, Germany
| | | | | | | |
Collapse
|
3
|
Perthus A, Colin F, Charton E, Anota A, Lhomme F, Manson G, De Guibert S, Daufresne P, Bellec A, Le Bars L, De Barros S, Ysebaert L, Merceur M, Cogné M, Lamy De La Chapelle T, Houot R, Moignet A. Remission after CAR T-cell therapy: Do lymphoma patients recover a normal life? Hemasphere 2024; 8:e72. [PMID: 38803454 PMCID: PMC11129324 DOI: 10.1002/hem3.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/14/2024] [Accepted: 03/28/2024] [Indexed: 05/29/2024] Open
Abstract
Chimeric antigen receptor T cells (CAR T cells) can induce prolonged remission in a substantial subset of patients with relapse/refractory lymphoma. However, little is known about patients' life after CAR T-cell therapy. We prospectively assessed the multidimensional recovery of lymphoma patients in remission, before leukapheresis, before CAR T-cell infusion, and 3, 6, and 12 months thereafter. Validated tools were used to measure lymphoma-related and global health-related quality of life (HRQoL; Functional Assessment of Cancer Therapy-Lymphoma [FACT-Lym] and EQ-5D-5L), cognitive complaint (FACT-Cognition), fatigue (FACIT-Fatigue subscale), psychological status (Hospital Anxiety and Depression Scale, Post-Traumatic Check List Scale), and sexuality (Relationship and Sexuality Scale). Beyond 12 months of remission, we also surveyed physical, professional, sexual, and general life status. At 3, 6, and 12 months, 53, 35, and 23 patients were evaluable, respectively. Improvement in lymphoma-related HRQoL was clinically relevant at 3, 6, and 12 months with a mean change from baseline of 10.9 (95% confidence interval [CI]: 5.8; 16.1), 12.2 (95% CI: 4.2; 20.1), and 11.72 (95% CI: 2.06; 21.38), respectively. Improvement in global HRQoL, fatigue, and anxiety was clinically relevant, but 20%-40% of patients experienced persistent fatigue, psychological distress, and cognitive complaints over time. Beyond 12 months after CAR T cells, 81.8% of 22 evaluable patients were satisfied with their daily life. Physical activity, professional, sexual, and global well-being had returned to prediagnosis levels in nearly half of the patients. We found an improvement in HRQoL after CAR T-cell therapy including anxiety, depression, sexual satisfaction, and general well-being. However, not all patients recover a "normal life." Further research is needed to determine which patients are at risk of quality-of-life impairment to improve recovery after CAR T-cell infusion.
Collapse
Affiliation(s)
- Alya Perthus
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Fanny Colin
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Emilie Charton
- Human and Social Sciences DepartmentLeon Berard CenterLyonFrance
| | - Amélie Anota
- Human and Social Sciences DepartmentLeon Berard CenterLyonFrance
- Department of Clinical Research and InnovationLeon Berard CenterLyonFrance
| | - Faustine Lhomme
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Guillaume Manson
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Sophie De Guibert
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Pierre Daufresne
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Adeline Bellec
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Laetitia Le Bars
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| | - Sandra De Barros
- Department of HematologyCancer University Institute of Toulouse OncopoleToulouseFrance
| | - Loïc Ysebaert
- Department of HematologyCancer University Institute of Toulouse OncopoleToulouseFrance
| | - Marianne Merceur
- Department of Physical and Rehabilitation MedicineUniversity Hospital of RennesRennesFrance
| | - Mélanie Cogné
- Department of Physical and Rehabilitation MedicineUniversity Hospital of RennesRennesFrance
| | - Thierry Lamy De La Chapelle
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
- UMR U1236, INSERMUniversity of RennesRennesFrance
| | - Roch Houot
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
- UMR U1236, INSERMUniversity of RennesRennesFrance
| | - Aline Moignet
- Service d'Hématologie—CHU Pontchaillou, Department of HematologyUniversity Hospital of RennesRennesFrance
| |
Collapse
|
4
|
Hamadani M, Spira A, Zhou X, Liao L, Chen L, Radford J, Ai W, Solh M, Ardeshna KM, Hess B, Caimi PF, Stathis A, Carlo-Stella C, Alderuccio JP, Kahl B, Wang Y, Qin Y, Xu ZC, Zinzani PL. Clinical outcomes of older and younger patients treated with loncastuximab tesirine in the LOTIS-2 clinical trial. Blood Adv 2024; 8:93-98. [PMID: 37871303 PMCID: PMC10787240 DOI: 10.1182/bloodadvances.2023010636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/03/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023] Open
Affiliation(s)
- Mehdi Hamadani
- Division of Hematology and Oncology, BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI
| | | | - Xiaolei Zhou
- RTI Health Solutions, Research Triangle Park, NC
| | - Laura Liao
- ADC Therapeutics America Inc, Murray Hill, NJ
| | - Lei Chen
- ADC Therapeutics America Inc, Murray Hill, NJ
| | - John Radford
- NIHR Clinical Research Facility, University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Weiyun Ai
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | - Melhem Solh
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA
| | - Kirit M. Ardeshna
- Cancer Division, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Brian Hess
- Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Paolo F. Caimi
- Blood and Marrow Transplant Program, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH
| | | | - Carmelo Carlo-Stella
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Oncology and Hematology, Humanitas Research Hospital−IRCCS, Milan, Italy
| | - Juan Pablo Alderuccio
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL
| | - Brad Kahl
- Division of Oncology, Washington University, St. Louis, MO
| | - Ying Wang
- ADC Therapeutics America Inc, Murray Hill, NJ
| | - Yajuan Qin
- ADC Therapeutics America Inc, Murray Hill, NJ
| | | | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia Seràgnoli, Bologna, Italy
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| |
Collapse
|
5
|
Dubuy Y, Sébille V, Bourdon M, Hardouin JB, Blanchin M. Posttraumatic growth inventory: challenges with its validation among French cancer patients. BMC Med Res Methodol 2022; 22:246. [PMID: 36153507 PMCID: PMC9508777 DOI: 10.1186/s12874-022-01722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
Background The Posttraumatic growth inventory (PTGI) aims to assess the positive psychological changes that individuals can perceive after a traumatic life event such as a cancer diagnosis. Several French translations of the PTGI have been proposed, but comprehensive data on their psychometric properties are lacking. This study aimed to provide a more complete assessment of the psychometric properties of one of the most used PTGI translations in early-stage breast cancer and melanoma patients. Methods A sample of 379 patients completed the PTGI two years after their cancer diagnosis. A confirmatory analysis was first performed to determine whether the initial five-factor structure of the PTGI was adequate for this French version. As issues were identified in the translation and in the questionnaire structure, we performed an exploratory analysis to determine the most suitable structure for this questionnaire. Validity and reliability of the evidenced structured were then assessed. Results The exploratory analysis evidenced a four-factor structure close to the initial structure: four of the five initial domains were recovered, and items from the unrecovered domain were split into the other domains. This new structure showed good internal consistency and acceptable validity. Conclusions This study highlights that the process of translation and cross-cultural validation of questionnaires is crucial to obtain valid and reliable psychometric instruments. We advise French psycho-oncology researchers and psychotherapists to (i) use the revised translation of Lelorain et al. (2010) proposed in this manuscript and (ii) use the four scores newly evidenced with a grouping of two response categories. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01722-6.
Collapse
|