Relationship between physician-adjudicated adverse events and patient-reported health-related quality of life in a phase II clinical trial (NCT01143402) of patients with metastatic uveal melanoma Journal Article


Authors: Atkinson, T. M.; Hay, J. L.; Shoushtari, A.; Li, Y.; Paucar, D. J.; Smith, S. C.; Kudchadkar, R. R.; Doyle, A.; Sosman, J. A.; Quevedo, J. F.; Milhem, M. M.; Joshua, A. M.; Linette, G. P.; Gajewski, T. F.; Lutzky, J.; Lawson, D. H.; Lao, C. D.; Flynn, P. J.; Albertini, M. R.; Sato, T.; Lewis, K.; Marr, B.; Abramson, D. H.; Dickson, M. A.; Schwartz, G. K.; Carvajal, R. D.
Article Title: Relationship between physician-adjudicated adverse events and patient-reported health-related quality of life in a phase II clinical trial (NCT01143402) of patients with metastatic uveal melanoma
Abstract: Purpose: Clinical trials commonly use physician-adjudicated adverse event (AE) assessment via the common terminology criteria for adverse events (CTCAE) for decision-making. Patient-reported health-related quality of life (HRQoL) data are becoming more frequent in oncology; however, the relationship between physician-adjudicated AE assessment and HRQoL is understudied. Methods: Data from a phase II trial (clinicaltrials.gov identifier: NCT01143402) where patients with metastatic uveal melanoma were randomized to receive selumetinib, an oral MEK inhibitor, or chemotherapy were analyzed. Patients reported HRQoL at baseline, after 1 month, and end of treatment (n = 118), whereas physicians adjudicated AEs via CTCAE. Mean HRQoL scores were compared between patient randomization arms, as well as between those patients who did/did not receive dose modifications. Results: Ninety-four percent had a CTCAE grade ≥1 for at least one treatment-associated AE, with 18% undergoing dose modification due to toxicity. Mean HRQoL scores did not significantly differ at each of the three time points. Patient and physician-adjudicated reports of nausea were significantly correlated at the start (r = 0.31, p < 0.01) and end of treatment (r = 0.42, p < 0.05). There were no significant correlations between need for dose modification and HRQoL scores. Conclusions: Despite the high rate of physician-adjudicated AEs and need for dose modifications with selumetinib, patient-reported HRQoL was not impacted by treatment. Since HRQoL did not differ in the subgroup of patients who received dosage reductions due to AEs, patients may be willing to tolerate select AEs without dose modification (if medically appropriate). More research is needed to determine how to best integrate HRQoL data into clinical trial conduct. © 2016, Springer-Verlag Berlin Heidelberg.
Keywords: adult; controlled study; aged; middle aged; clinical trial; neoplasms; melanoma; quality of life; phase 2 clinical trial; randomized controlled trial; pathology; physicians; physician; patient-reported outcomes; patient reported outcome measures; uveal neoplasms; clinical trials; benzimidazole derivative; benzimidazoles; adverse events; patient-reported outcome; uveal melanoma; selumetinib; humans; human; male; female; drug-related side effects and adverse reactions
Journal Title: Journal of Cancer Research and Clinical Oncology
Volume: 143
Issue: 3
ISSN: 0171-5216
Publisher: Springer  
Date Published: 2017-03-01
Start Page: 439
End Page: 445
Language: English
DOI: 10.1007/s00432-016-2318-x
PUBMED: 27921276
PROVIDER: scopus
PMCID: PMC5303646
DOI/URL:
Notes: Article -- Export Date: 2 March 2017 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Yuelin Li
    140 Li
  2. Brian Marr
    108 Marr
  3. David H Abramson
    255 Abramson
  4. Mark Andrew Dickson
    79 Dickson
  5. Jennifer L Hay
    163 Hay
  6. Sloane Camille Baptiste Smith
    6 Smith