Symptom burden for patients with metastatic colorectal cancer treated with first-line FOLFOX or FOLFIRI with and without bevacizumab in the community setting

Barry V. Fortner, Lee Schwartzberg, Edward J. Stepanski, Arthur C. Houts

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: FOLFOX (oxaliplatin/leucovorin/5-fluorouracil) and FOLFIRI (irinotecan/leucovorin/5-fluorouracil) with or without bevacizumab have become standard-of-care regimens in first-line treatment of metastatic colorectal cancer. However, there is a paucity of symptom burden information regarding these regimens from the patient perspective in community oncology. Patients and Methods: This retrospective chart review and telephone interview study examined patients with first-line metastatic colorectal cancer from 5 community oncology centers treated with FOLFOX or FOLFIRI with and without bevacizumab. Patient-reported outcomes were taken from the Patient Care Monitor 1.0 Revised, a validated tablet computer-based questionnaire that measures symptom burden and several scales of functioning and quality of life. A subset of patients completed structured telephone interviews about the impact of treatment on practical activities and income. Results: Eighty-eight patients with an average age of 62 years were included. Patients completed a median of 8 cycles of treatment. The most common moderate to severe symptom complaint was fatigue. Gastrointestinal symptoms were common but did not cluster in one regimen versus another. Neuropathy-related symptoms were also common across all regimens except FOLFIRI without bevacizumab. Nausea and neutropenia were common indications for concomitant medications. One third reported work and other activity interference, and care produced out-of-pocket expenditures in excess of $1000. Conclusion: Although sample size was small in the FOLFIRI-based regimens, patient reports and chart records suggested that there was not a systematic difference between FOLFOX and FOLFIRI regimens in type of symptom. The addition of bevacizumab did not appear to increase symptom burden.

Original languageEnglish (US)
Pages (from-to)233-240
Number of pages8
JournalSupportive Cancer Therapy
Volume4
Issue number4
DOIs
StatePublished - Jan 1 2007

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Colorectal Neoplasms
oxaliplatin
irinotecan
Leucovorin
Fluorouracil
Interviews
Handheld Computers
Standard of Care
Health Expenditures
Bevacizumab
Neutropenia
Sample Size
Nausea
Fatigue
Patient Care
Therapeutics
Quality of Life

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pharmacology
  • Cancer Research

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Symptom burden for patients with metastatic colorectal cancer treated with first-line FOLFOX or FOLFIRI with and without bevacizumab in the community setting. / Fortner, Barry V.; Schwartzberg, Lee; Stepanski, Edward J.; Houts, Arthur C.

In: Supportive Cancer Therapy, Vol. 4, No. 4, 01.01.2007, p. 233-240.

Research output: Contribution to journalArticle

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abstract = "Background: FOLFOX (oxaliplatin/leucovorin/5-fluorouracil) and FOLFIRI (irinotecan/leucovorin/5-fluorouracil) with or without bevacizumab have become standard-of-care regimens in first-line treatment of metastatic colorectal cancer. However, there is a paucity of symptom burden information regarding these regimens from the patient perspective in community oncology. Patients and Methods: This retrospective chart review and telephone interview study examined patients with first-line metastatic colorectal cancer from 5 community oncology centers treated with FOLFOX or FOLFIRI with and without bevacizumab. Patient-reported outcomes were taken from the Patient Care Monitor 1.0 Revised, a validated tablet computer-based questionnaire that measures symptom burden and several scales of functioning and quality of life. A subset of patients completed structured telephone interviews about the impact of treatment on practical activities and income. Results: Eighty-eight patients with an average age of 62 years were included. Patients completed a median of 8 cycles of treatment. The most common moderate to severe symptom complaint was fatigue. Gastrointestinal symptoms were common but did not cluster in one regimen versus another. Neuropathy-related symptoms were also common across all regimens except FOLFIRI without bevacizumab. Nausea and neutropenia were common indications for concomitant medications. One third reported work and other activity interference, and care produced out-of-pocket expenditures in excess of $1000. Conclusion: Although sample size was small in the FOLFIRI-based regimens, patient reports and chart records suggested that there was not a systematic difference between FOLFOX and FOLFIRI regimens in type of symptom. The addition of bevacizumab did not appear to increase symptom burden.",
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