Abstract 1401P
Background
Quality of life (QoL) outcomes may differ among patients (pts) with prostate cancer (PCa) depending on disease setting, treatment received, and country/healthcare system.
Methods
In a large-scale, self-report digital survey, pts with non-metastatic (M–) and metastatic (M+) PCa in Germany, the UK and the US reported demographic and clinical factors, disease and treatment history, and QoL using validated measures (e.g., Functional Assessment of Cancer Therapy – Prostate [FACT-P]). Pts also rated their degree of positive vs. negative views of each type of PCa therapy not (yet) received and expected impact on QoL. Predictors of QoL were examined using analysis of variance, t-tests, and chi-square tests. Multivariate regression analysis examined the relative impact of one predictor while controlling for others. We assessed for between-group differences > 10, the previously defined cutoff for clinically meaningful FACT-P differences.
Results
Among 15 511 pts, 20% had M+ PCa and 37% had symptoms at diagnosis; 23% had diabetes, 27% cardiovascular disease and 9% kidney disease. Demographic factors were similar across countries. Pts had mostly negative views of therapy not yet received and expected negative impact on QoL. On univariate analysis, FACT-P scores were significantly better among pts with M– vs. M+ disease, pts with no comorbidities vs. ≥ 2 comorbidities and pts without vs. with severe comorbidity (Table). Age and PCa symptoms at diagnosis were not meaningfully associated with FACT-P scores. On multivariate analysis, M– vs. M+ disease and no comorbidities vs. ≥ 2 comorbidities showed meaningful differences in QoL. Table: 1401P
Average FACT-P scores across predictors
| Total FACT-P score, mean (SD) | ||
| Country | Germany | 117 (22) |
| UK | 114 (23) | |
| US | 115 (23) | |
| Age, years | ≤ 59 | 112 (26) |
| 60–69 | 115 (23) | |
| 70–79 | 116 (21) | |
| ≥ 80 | 113 (21) | |
| Metastatic disease* † | No | 118 (21) |
| Yes | 105 (23) | |
| Therapy received | None | 114 (23) |
| Any | 115 (23) | |
| Symptoms at diagnosis | No | 118 (21) |
| Yes | 110 (24) | |
| Comorbidities* † | 0 | 119 (21) |
| 1 | 113 (22) | |
| ≥ 2 | 105 (24) | |
| Diabetes* | No | 117 (22) |
| Mild | 110 (23) | |
| Moderate | 109 (23) | |
| Severe | 89 (23) | |
| Cardiovascular disease* | No | 118 (22) |
| Mild | 110 (23) | |
| Moderate | 110 (23) | |
| Severe | 91 (28) | |
| Kidney disease* | No | 117(22) |
| Mild | 108 (24) | |
| Moderate | 104 (24) | |
| Severe | 91 (31) |
Clinically meaningful difference in QoL in *univariate and †multivariate analyses
Conclusions
Self-reported QoL in pts with PCa did not vary substantially by country though treatment strategies differ. QoL was significantly affected by M+ status and comorbidity burden. QoL interventions should target these at-risk groups to reduce symptom burden, tolerance of treatment and fear of therapy.
Clinical trial identification
Editorial acknowledgement
Under the guidance of the authors, Charlie Foster, PhD from Oxford PharmaGenesis (Oxford, UK) provided medical writing support for this abstract, with funding from Advanced Accelerator Applications, a Novartis Company.
Legal entity responsible for the study
Advanced Accelerator Applications, a Novartis Company.
Funding
Advanced Accelerator Applications, a Novartis Company.
Disclosure
J. O'Sullivan: Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, a Novartis Company, Astellas, Bayer, Janssen, Sanofi; Financial Interests, Personal, Speaker’s Bureau: Advanced Accelerator Applications, a Novartis Company, Astellas, Bayer, Janssen, Sanofi; Financial Interests, Institutional, Research Grant: Bayer. B.D. Gonzalez: Financial Interests, Personal, Other, Consulting: SureMed Compliance, KemPharm; Financial Interests, Personal, Advisory Board: EllyHealth; Financial Interests, Personal, Invited Speaker: Society of Behavioral Medicine. R. Lehmann: Financial Interests, Personal, Officer, Founder and CEO: DontBePatient Intelligence; Financial Interests, Institutional, Research Grant, Founbding of the Prostate Cancer Patient Survey: Novartis/AAA. A. Poschenrieder, O. Mirante: Financial Interests, Personal, Stocks/Shares, Employee of Advanced Accelerator Applications, a Novartis Company: Novartis. A.K. Morgans: Financial Interests, Personal, Advisory Board: Astellas, AstraZeneca, AAA, Bayer, Janssen, Exelixis, Myovant, Novartis, Pfizer, Sanofi; Financial Interests, Institutional, Research Grant: Astella, Bayer, Myovant, Sanofi. All other authors have declared no conflicts of interest.