Health related quality of life in older or frail patients with advanced colorectal cancer treated with dose reduced capecitabine

Daniel Breadner, Mark David Vincent, Derek Jonker, Christine Cripps, Paul Klimo, James Biagi, Wendy Lam, Anne O'Connell, Frances Whiston, Larry Stitt, Stephen Welch

Research output: Contribution to journalArticle

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Abstract

Objectives: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial. Methods: A single arm multi-centered phase II trial of dose reduced capecitabine (1500 or 2000 mg/m2 days one-fourteen q21 days) in older or frail patients. Participants (182 patients) were asked to complete Functional Assessment of Cancer Therapy general questionnaire (FACT-G) at enrollment, after each cycle of capecitabine, and once upon completion, if possible. Results: 157 patients completed a baseline questionnaire (86%), and 137 patients (75%) completed at least one subsequent questionnaire. The mean baseline score was 81.6, out of a possible 108. The mean score peaked at 92 after cycle 10. The mean change from baseline was always positive. Patients achieving the minimal clinically important difference (MCID) ranged from 30% to 45% during treatment. Higher baseline FACT-G and Physical Well-being score were independently prognostic for improved survival (p = 0.006 and p < 0.0001, respectively). Time until definitive deterioration (TUDD) was insignificantly longer in patients with a higher baseline FACT-G (p = 0.18). Conclusion: Baseline HRQoL scores were independently prognostic for survival, supporting their importance. Compared to full dose, reduced dose capecitabine has previously demonstrated equivalent efficacy and reduced toxicity. We have reported dose reduced capecitabine improves quality of life in older or frail patients with aCRC, further supporting its use in the management of aCRC.

Original languageEnglish (US)
Pages (from-to)659-664
Number of pages6
JournalJournal of Geriatric Oncology
Volume9
Issue number6
DOIs
StatePublished - Nov 1 2018

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Colorectal Neoplasms
Quality of Life
Survival
Therapeutics
Neoplasms
Capecitabine
Surveys and Questionnaires
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Geriatrics and Gerontology

Cite this

Health related quality of life in older or frail patients with advanced colorectal cancer treated with dose reduced capecitabine. / Breadner, Daniel; Vincent, Mark David; Jonker, Derek; Cripps, Christine; Klimo, Paul; Biagi, James; Lam, Wendy; O'Connell, Anne; Whiston, Frances; Stitt, Larry; Welch, Stephen.

In: Journal of Geriatric Oncology, Vol. 9, No. 6, 01.11.2018, p. 659-664.

Research output: Contribution to journalArticle

Breadner, D, Vincent, MD, Jonker, D, Cripps, C, Klimo, P, Biagi, J, Lam, W, O'Connell, A, Whiston, F, Stitt, L & Welch, S 2018, 'Health related quality of life in older or frail patients with advanced colorectal cancer treated with dose reduced capecitabine', Journal of Geriatric Oncology, vol. 9, no. 6, pp. 659-664. https://doi.org/10.1016/j.jgo.2018.04.002
Breadner, Daniel ; Vincent, Mark David ; Jonker, Derek ; Cripps, Christine ; Klimo, Paul ; Biagi, James ; Lam, Wendy ; O'Connell, Anne ; Whiston, Frances ; Stitt, Larry ; Welch, Stephen. / Health related quality of life in older or frail patients with advanced colorectal cancer treated with dose reduced capecitabine. In: Journal of Geriatric Oncology. 2018 ; Vol. 9, No. 6. pp. 659-664.
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abstract = "Objectives: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial. Methods: A single arm multi-centered phase II trial of dose reduced capecitabine (1500 or 2000 mg/m2 days one-fourteen q21 days) in older or frail patients. Participants (182 patients) were asked to complete Functional Assessment of Cancer Therapy general questionnaire (FACT-G) at enrollment, after each cycle of capecitabine, and once upon completion, if possible. Results: 157 patients completed a baseline questionnaire (86{\%}), and 137 patients (75{\%}) completed at least one subsequent questionnaire. The mean baseline score was 81.6, out of a possible 108. The mean score peaked at 92 after cycle 10. The mean change from baseline was always positive. Patients achieving the minimal clinically important difference (MCID) ranged from 30{\%} to 45{\%} during treatment. Higher baseline FACT-G and Physical Well-being score were independently prognostic for improved survival (p = 0.006 and p < 0.0001, respectively). Time until definitive deterioration (TUDD) was insignificantly longer in patients with a higher baseline FACT-G (p = 0.18). Conclusion: Baseline HRQoL scores were independently prognostic for survival, supporting their importance. Compared to full dose, reduced dose capecitabine has previously demonstrated equivalent efficacy and reduced toxicity. We have reported dose reduced capecitabine improves quality of life in older or frail patients with aCRC, further supporting its use in the management of aCRC.",
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AU - Klimo, Paul

AU - Biagi, James

AU - Lam, Wendy

AU - O'Connell, Anne

AU - Whiston, Frances

AU - Stitt, Larry

AU - Welch, Stephen

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N2 - Objectives: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial. Methods: A single arm multi-centered phase II trial of dose reduced capecitabine (1500 or 2000 mg/m2 days one-fourteen q21 days) in older or frail patients. Participants (182 patients) were asked to complete Functional Assessment of Cancer Therapy general questionnaire (FACT-G) at enrollment, after each cycle of capecitabine, and once upon completion, if possible. Results: 157 patients completed a baseline questionnaire (86%), and 137 patients (75%) completed at least one subsequent questionnaire. The mean baseline score was 81.6, out of a possible 108. The mean score peaked at 92 after cycle 10. The mean change from baseline was always positive. Patients achieving the minimal clinically important difference (MCID) ranged from 30% to 45% during treatment. Higher baseline FACT-G and Physical Well-being score were independently prognostic for improved survival (p = 0.006 and p < 0.0001, respectively). Time until definitive deterioration (TUDD) was insignificantly longer in patients with a higher baseline FACT-G (p = 0.18). Conclusion: Baseline HRQoL scores were independently prognostic for survival, supporting their importance. Compared to full dose, reduced dose capecitabine has previously demonstrated equivalent efficacy and reduced toxicity. We have reported dose reduced capecitabine improves quality of life in older or frail patients with aCRC, further supporting its use in the management of aCRC.

AB - Objectives: Palliative chemotherapy's role is to prolong survival while minimizing treatment toxicities to preserve or improve quality of life. We have recently published a phase II trial of dose reduced capecitabine in older or frail patients with advanced colorectal cancer (aCRC). We herein provide a robust analysis of the health related quality of life (HRQoL) data from our trial. Methods: A single arm multi-centered phase II trial of dose reduced capecitabine (1500 or 2000 mg/m2 days one-fourteen q21 days) in older or frail patients. Participants (182 patients) were asked to complete Functional Assessment of Cancer Therapy general questionnaire (FACT-G) at enrollment, after each cycle of capecitabine, and once upon completion, if possible. Results: 157 patients completed a baseline questionnaire (86%), and 137 patients (75%) completed at least one subsequent questionnaire. The mean baseline score was 81.6, out of a possible 108. The mean score peaked at 92 after cycle 10. The mean change from baseline was always positive. Patients achieving the minimal clinically important difference (MCID) ranged from 30% to 45% during treatment. Higher baseline FACT-G and Physical Well-being score were independently prognostic for improved survival (p = 0.006 and p < 0.0001, respectively). Time until definitive deterioration (TUDD) was insignificantly longer in patients with a higher baseline FACT-G (p = 0.18). Conclusion: Baseline HRQoL scores were independently prognostic for survival, supporting their importance. Compared to full dose, reduced dose capecitabine has previously demonstrated equivalent efficacy and reduced toxicity. We have reported dose reduced capecitabine improves quality of life in older or frail patients with aCRC, further supporting its use in the management of aCRC.

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