Baseline quality of life as a prognostic survival tool in patients receiving sunitinib for metastatic renal cell carcinoma Journal Article


Authors: Cella, D.; Bushmakin, A. G.; Cappelleri, J. C.; Charbonneau, C.; Michaelson, M. D.; Motzer, R. J.
Article Title: Baseline quality of life as a prognostic survival tool in patients receiving sunitinib for metastatic renal cell carcinoma
Abstract: BACKGROUND: In a randomized phase III trial of sunitinib vs interferon-alfa (IFN-α) in metastatic renal cell carcinoma (mRCC), better baseline quality of life (QoL) was predictive of longer survival. Using this dataset, we have developed a novel prognostic tool that establishes a relationship between baseline QoL scores and median survival time. METHODS: Baseline QoL was assessed using the FACT-Kidney Symptom Index-15 item (FKSI-15), its disease-related symptoms (FKSI-DRS) subscale, and the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Weibull models estimated median progression-free survival (mPFS) and overall survival (mOS) as a function of baseline QoL. RESULTS: Longer PFS and OS were associated with higher baseline FKSI-15, FKSI-DRS, and FACT-G scores (P<0.05), and baseline FKSI-15 score was the best predictor of survival. For example, for a baseline FKSI-15 score of 60, the predicted mPFS was 67.9 weeks, and predicted mOS was 240.6 weeks. The magnitude of benefit was greater with sunitinib vs IFN-α for a given baseline QoL score. CONCLUSION: This novel tool indicates that baseline FKSI-15 scores were linked to mPFS and mOS in a clear and interpretable way. The results support evaluation of patient-reported QoL symptoms at baseline as a prognostic indicator of survival in clinical research and practice. © 2012 Cancer Research UK. All rights reserved.
Keywords: survival; adult; cancer survival; controlled study; functional assessment; major clinical study; overall survival; sunitinib; alpha interferon; sensitivity analysis; progression free survival; quality of life; randomized controlled trial; kidney carcinoma; survival time; phase 3 clinical trial; predictive value; metastatic renal cell carcinoma; prognostic tool; weibull model
Journal Title: British Journal of Cancer
Volume: 106
Issue: 4
ISSN: 0007-0920
Publisher: Nature Publishing Group  
Date Published: 2012-02-01
Start Page: 646
End Page: 650
Language: English
DOI: 10.1038/bjc.2011.589
PROVIDER: scopus
PUBMED: 22240794
PMCID: PMC3322947
DOI/URL:
Notes: --- - "Export Date: 2 April 2012" - "CODEN: BJCAA" - "Source: Scopus"
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  1. Robert Motzer
    950 Motzer