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Quality of Life in Men With Prostate Cancer Randomly Allocated to Receive Docetaxel or Abiraterone in the STAMPEDE Trial.

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Date
2021-11-10
ICR Author
Parker, Chris
Dearnaley, David
James, Nicholas
Author
Rush, HL
Murphy, L
Morgans, AK
Clarke, NW
Cook, AD
Attard, G
Macnair, A
Dearnaley, DP
Parker, CC
Russell, JM
Gillessen, S
Matheson, D
Millman, R
Brawley, CD
Pugh, C
Tanguay, JS
Jones, RJ
Wagstaff, J
Rudman, S
O'Sullivan, JM
Gale, J
Birtle, A
Protheroe, A
Gray, E
Perna, C
Tolan, S
McPhail, N
Malik, ZI
Vengalil, S
Fackrell, D
Hoskin, P
Sydes, MR
Chowdhury, S
Gilbert, DC
Parmar, MKB
James, ND
Langley, RE
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Type
Journal Article
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Abstract
<h4>Purpose</h4>Docetaxel and abiraterone acetate plus prednisone or prednisolone (AAP) both improve survival when commenced alongside standard of care (SOC) androgen deprivation therapy in locally advanced or metastatic hormone-sensitive prostate cancer. Thus, patient-reported quality of life (QOL) data may guide treatment choices.<h4>Methods</h4>A group of patients within the STAMPEDE trial were contemporaneously enrolled with the possibility of being randomly allocated to receive either docetaxel + SOC or AAP + SOC. A mixed-model assessed QOL in those who had completed at least one QLQ-C30 + PR25 questionnaire. The primary outcome measure was difference in global-QOL (QLQ-C30 Q29&30) between patients allocated to docetaxel + SOC or AAP + SOC over the 2 years after random assignment, with a predefined criterion for clinically meaningful difference of > 4.0 points. Secondary outcome measures included longitudinal comparison of functional domains, pain, and fatigue, plus global-QOL at defined timepoints.<h4>Results</h4>Five hundred fifteen patients (173 docetaxel + SOC and 342 AAP + SOC) were included. Baseline characteristics, proportion of missing data, and mean baseline global-QOL scores (docetaxel + SOC 77.8 and AAP + SOC 78.0) were similar. Over the 2 years following random assignment, the mean modeled global-QOL score was +3.9 points (95% CI, +0.5 to +7.2; <i>P</i> = .022) higher in patients allocated to AAP + SOC. Global-QOL was higher for patients allocated to AAP + SOC over the first year (+5.7 points, 95% CI, +3.0 to +8.5; <i>P</i> < .001), particularly at 12 (+7.0 points, 95% CI, +3.0 to +11.0; <i>P</i> = .001) and 24 weeks (+8.3 points, 95% CI, +4.0 to +12.6; <i>P</i> < .001).<h4>Conclusion</h4>Patient-reported QOL was superior for patients allocated to receive AAP + SOC, compared with docetaxel + SOC over a 2-year period, narrowly missing the predefined value for clinical significance. Patients receiving AAP + SOC reported clinically meaningful higher global-QOL scores throughout the first year following random assignment.
URI
https://repository.icr.ac.uk/handle/internal/4997
DOI
https://doi.org/10.1200/jco.21.00728
https://doi.org/10.1200/jco.21.00728
 
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  • Closed Research Teams
  • Radiotherapy and Imaging
Research team
Clinical Academic Radiotherapy (Dearnaley)
Prostate and Bladder Cancer Research
Language
eng
Date accepted
2021-10-01
License start date
2021-11-10
Citation
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021, pp. JCO2100728 - ?

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