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    QoL prognostic in mCRPC patients on salvage therapy

    Longitudinal quality of life changes associated with rPFS, data indicate

    Chicago—Clinical outcomes of men with metastatic castration-resistant prostate cancer (mCRPC) treated with enzalutamide (XTANDI) after chemotherapy correlate with health-related quality of life (HRQoL) both at treatment initiation and its change longitudinally, researchers reported at the American Society of Clinical Oncology annual meeting in Chicago.

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    The findings were derived from post-hoc analyses of data collected prospectively during the phase III AFFIRM study in which 1,199 men with mCRPC who had failed docetaxel (Taxotere) were randomized 2:1 to treatment with enzalutamide, 160 mg/day, or placebo. HRQoL was assessed during the trial using the validated Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, which was completed before randomization, at week 13, and every 12 weeks thereafter while on study treatment.

    Correlations between FACT-P scores were explored with both overall survival and radiographic progression-free survival (rPFS). The results showed that for both clinical outcomes, the prognosis was better for men with better HRQoL at baseline and also if their HRQoL improved during treatment with enzalutamide.

    “In the future, the findings from these analyses represent additional information that might be included for shared decision-making about initiating enzalutamide after chemotherapy for men with mCRPC failing chemotherapy and also for deciding whether or not to continue enzalutamide treatment,” said first author Kurt Miller, MD, PhD, speaking to Urology Times on behalf of the AFFIRM investigators.

    “However, more studies are needed to validate these observations and to demonstrate that therapy selection based on quality of life helps patients,” added Dr. Miller, chair of urology at Charité Universitätsmedizin, Berlin.

    The prognostic value of baseline and time-dependent HRQoL scores was investigated using a multivariate Cox regression model that adjusted for treatment and relevant clinical and demographic variables. Separate analyses were performed using the total FACT-P score and for scores in the subdomains of physical well-being, functional well-being, and “additional concerns” (subscale consisting of items relating to prostate cancer and its treatment).

    Next: FACT-P scores correlate with rPFS

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