Abstract 2722
Background
Sunitinib (SU) was FDA-approved for adjuvant treatment of patients (pts) with renal cell carcinoma (RCC) at high risk of recurrence post nephrectomy, based upon a 24% reduction in disease-free survival with up to 1 year of SU treatment vs placebo (PBO) (S-TRAC trial). The analysis of patient-reported outcomes (PRO) data showed a statistically significant difference favoring PBO in most EORTC QLQ-C30 scales, and in the symptoms appetite loss and diarrhea, a clinically meaningful difference (≥ 10 points) favoring PBO was observed. Recognizing that some pts did not tolerate SU early on, with higher discontinuation and dose reduction rates for SU than PBO, we describe a baseline reset analysis to assess the longitudinal PRO profile of pts who were able to tolerate and stay on treatment beyond the first 2 cycles (C).
Methods
After censoring the data from C1 and 2, and resetting a new baseline at C 3, the baseline reset analysis described here used the same statistical analysis done for PRO data in S-TRAC. For each scale, comparison of the two treatment arms was carried out using longitudinal repeated measures mixed effect.
Results
Of the 615 pts enrolled in S-TRAC, 580 were included in the PRO analyses. Of these, 506 pts had PRO data at C 3 and were included in this analysis. The longitudinal between treatment comparison resulted in statistically significant differences favoring PBO in 6 of the 15 scales with no clinically meaningful differences (≥10 points) (see Table). The discontinuation rates of the 2 treatment groups were comparable from C 3 onward.Table: 916P
Summary results: EORTC QLQ-C30: Scores between treatment comparison – intent-to-treat population (cycles 3-9)
Sunitinib (n = 241) Model Estimated Mean | Placebo (n = 265) Model Estimated Mean | Difference (Sunitinib – Placebo) | |
---|---|---|---|
EORTC QLQ-C30 | |||
Global Health status/QoL (large values better) | 69.87 | 72.20 | -2.32* |
Functional scales (large values better) | |||
Physical functioning | 85.12 | 86.18 | -1.06 |
Role functioning | 80.84 | 83.49 | -2.65* |
Emotional functioning | 81.52 | 82.49 | -0.97 |
Cognitive functioning | 85.59 | 86.35 | -0.76 |
Social functioning | 83.10 | 85.31 | -2.22* |
Symptom items/scales (large values worse) | |||
Fatigue | 27.40 | 24.55 | 2.85* |
Nausea and vomiting | 6.50 | 5.30 | 1.21 |
Pain | 20.78 | 18.68 | 2.10 |
Dyspnea | 14.36 | 14.04 | 0.32 |
Insomnia | 20.71 | 20.89 | -0.18 |
Appetite loss | 12.21 | 7.74 | 4.47 * |
Constipation | 10.46 | 10.63 | -0.17 |
Diarrhea | 18.67 | 10.67 | 8.00 * |
Financial difficulties | 14.10 | 13.53 | 0.58 |
A repeated measures longitudinal analysis with an intercept term, and treatment, time, treatment by time, and baseline as covariate over all cycles.
*P < 0.05
P-values not adjusted for multiplicity.
Conclusions
These analyses suggest that for pts who are able to tolerate SU for > 2 cycles (3 months), PRO profiles for SU are similar to PBO pts with similar discontinuation rates. Some pts do not tolerate SU early on in the adjuvant setting, but for the majority who do, long term tolerance may be more acceptable than originally thought.
Clinical trial identification
NCT00375674.
Legal entity responsible for the study
Pfizer Inc.
Funding
Pfizer.
Editorial Acknowledgement
Disclosure
D.J. George: Honoraria & Consulting: Sanofi, Exelixis, Bayer; Consulting: Merck, Sanofi; Grants: Genentech/Roche, Novartis, Astellas, Celldex, Acerta; Grants & Consulting: Exelixis, Janssen, Pfizer, Innocrin Pharma, BMS. R. Figlin: Funding: Merck, Pfizer, Peloton, Calithera; Consulting fees: Pfizer. R.J. Motzer: Consulting fees: Pfizer, Eisai, Novartis, Exelixis; Clinical trial support to institution: Pfizer, Eisai, Novartis, Bristol-Myers Squibb, Genentech/Roche, Exelixis. M.J. Lechuga Frean, G. Zanotti, H. Bhattacharyya, K. Ramaswamy, L. Deannuntis: Employee of and owns stock in Pfizer. A. Ravaud: Advisory boards: Pfizer, Novartis, GSK, Roche, BMS; Institutional support grants: Pfizer, Novartis; Housing and transportation for meetings and speeches: Pfizer, Novartis, BMS. All other authors have declared no conflicts of interest.
Resources from the same session
2595 - Real-Life Utilization of Genomic testing for invasive Breast Cancer patients in Italy and France reduces Chemotherapy Recommendations
Presenter: Sandro Barni
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2343 - Benefit of adjuvant chemotherapy in hormone receptor-positive, HER2-negative, invasive lobular carcinoma of the breast
Presenter: Alexandre De Nonneville
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2990 - Baseline lymphocyte counts predict distant recurrence in early breast cancer
Presenter: Gun Min Kim
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4532 - A propensity score analysis exploring the impact of the addition of adjuvant chemotherapy (aCT) to hormone therapy (aHT) in a multi-center series of resected luminal early stage pure Invasive Lobular Breast Carcinoma (ILC).
Presenter: Luisa Carbognin
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
2344 - Benefit of Adjuvant Systemic Therapies in HR+ HER2- pT1ab Node-Negative Breast Carcinomas
Presenter: Alexandre De Nonneville
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3525 - Anti-proliferative effect of oral metronomic vinorelbine in PAM50 Luminal/HER2-negative early breast cancer (SOLTI-1501 VENTANA): an open-label, randomized, three-arm, multicenter, window-of-opportunity study
Presenter: Aleix Prat
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3908 - Clinicopathologic significance of androgen receptor expression and discordant receptor status during progression in breast cancer
Presenter: Chan Heun Park
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
4075 - The outcomes of early breast cancers utilizing the Oncotype Dx Recurrence score (RS) instead of Clinico-pathological (CP) factors for prognostic risk assessment: A Single Institution Experience
Presenter: Adhar Alsayed
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
738 - Circulating tumor cells as a prognostic marker in non metastatic breast cancer patients.
Presenter: Summar Elmorshidy
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract
3151 - Molecular subtyping of breast cancer by dedicated breast PET
Presenter: Satoshi Sueoka
Session: Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care
Resources:
Abstract