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Mini Oral session: GI, upper digestive

54MO - Quality of life (QoL) and value of health (V-He) in advanced biliary cancers (ABC) treated with second-line active-symptom-control (ASC) alone or ASC with oxaliplatin/5-FU chemotherapy (ASC+FOLFOX) in the randomised phase III, multi-centre, open-label ABC-06 trial

Date

10 Sep 2022

Session

Mini Oral session: GI, upper digestive

Topics

Tumour Site

Hepatobiliary Cancers

Presenters

Angela Lamarca

Citation

Annals of Oncology (2022) 33 (suppl_7): S19-S26. 10.1016/annonc/annonc1036

Authors

A. Lamarca1, D. Palmer2, H.S. Wasan3, P. Ross4, Y.T. Ma5, A. Arora6, S. Falk7, R. Gillmore8, J. Wadsley9, K. Patel10, A. Anthoney11, A. Maravellas12, J.S.C. Waters13, C. Hoobs14, T. Macdonald15, D. Ryder15, J. Ramage16, L. Davies17, J.A. Bridgewater18, J.W. Valle19

Author affiliations

  • 1 Department Of Medical Oncology, The Christie NHS Foundation Trust, M20 4BX - Manchester/GB
  • 2 Clatterbridge Cancer Centre Wirral, The Clatterbridge Cancer Centre NHS Foundation Trust, CH63 4JY - Wirral/GB
  • 3 Oncology Dept., Hammersmith Hospital - Imperial College Healthcare NHS Trust, W12 0HS - London/GB
  • 4 Medical Oncology Department, Guy's Hospital, SE1 9RT - London/GB
  • 5 Medical Oncology Department, The University of Birmingham - Institute for Cancer Studies, B15 2TT - Birmingham/GB
  • 6 Oncology Dept, City Hospital Campus - Nottingham University Hospitals NHS Trust, NG5 1PB - Nottingham/GB
  • 7 Medical Oncology Department, NHS, BS2 8ED - Bristol/GB
  • 8 Department Of Medical Oncology, Royal Free Hospital, London/GB
  • 9 Clinical Oncology Dept., Weston Park Hospital - Sheffield Teaching Hospitals NHS Foundation Trust, S10 2SJ - Sheffield/GB
  • 10 Medical Oncology Department, John Radcliffe Hospital University of Oxford, OX3 9DU - Oxford/GB
  • 11 Institute Of Cancer And Pathology, St. James's University Hospital - Leeds Teaching Hospitals NHS Trust, LS9 7TF - Leeds/GB
  • 12 Medical Oncology Department, Castle Hill Hospital - Hull University Teaching Hospitals NHS Trust, HU16 5JQ - Cottingham/GB
  • 13 Kent Oncology Centre, Maidstone Hospital - Maidstone and Tunbridge NHS Trust, ME16 9QQ - Maidstone/GB
  • 14 Medical Oncology Department, The Great Western Hospital, SN3 6BB - Swindon/GB
  • 15 Clinical Trials Unit, The University of Manchester, M13 9PL - Manchester/GB
  • 16 Medical Oncology Department, NHS Hampshire Hospitals Foundation Trust - Basingstoke and North Hampshire Hospital, RG24 9NA - Basingstoke/GB
  • 17 Health Economics, The University of Manchester, M13 9PL - Manchester/GB
  • 18 Medical Oncology Department, UCL Cancer Institute - Paul O'Gorman Building, WC1 E6JD - London/GB
  • 19 Medical Oncology, The University of Manchester, M13 9PL - Manchester/GB

Resources

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Abstract 54MO

Background

The ABC-06 clinical trial stablished ASC+mFOLFOX as the standard of care treatment after Cisplatin and Gemcitabine (CisGem) for ABC but its impact on QoL has not been reported.

Methods

Within the ABC-06 study, patients (pts) diagnosed with ABC with progression after CisGem were randomised (1:1) to ASC+mFOLFOX or ASC. QoL (European Organisation for Research and Treatment of Cancer [EORTC] QLQ-30, QLQ-BIL21) and V-He (Euroqol EQ5D) questionnaires were completed at baseline and 12-weekly thereafter. Pateints who completed all or part of the EORTC or EQ-5D measure at baseline (BSL) were elegible. Follow-up data is reported for month 4 (M4) (follow-up visit that occurred up to 120 days post screening). Descriptive analyses,of the QoL measures by study arm are reported here; T-test was used for comparison between time-points (two-tailed p-value <0.05 was considered statistically significant).

Results

Out of 162 pts randomised, 138 were eligible for this available case analysis (65 ASC arm, 73 ASC+FOLFOX arm). Baseline characteristics and time from BSL to M4 visit were well balanced between both study arms. Addition of FOLFOX to ASC did not appear to induce worsening of the QOL parameters assessed (Table). In contrast, pts in the ASC-alone arm appeared to experience worsening of the EQ-5D utility values, and most of the QLQ-30 scales (including global, physical, social and role scales). There also appeared to be worsening of nausea and pain which remained stable in the ASC+FOLFOX arm. Table: 54MO

Measure Time-point ASC ASC+mFOLFOX
Mean p-value Interpretation Mean p-value Interpretation
EQ-5D utility value BSL 0.75 0.0309 0.77 0.6183
M4 0.62 0.70
QLQ-30 Summary score BSL 77 0.0446 79 0.1846
M4 64 71
QLQ-30 Global health scale BSL 67 0.0447 66 0.8295
M4 53 58
QLQ-30 Physical health scale BSL 74 0.0221 78 0.1238
M4 59 66
QLQ-30 Social function scale BSL 77 0.0272 76 0.1307
M4 61 65
QLQ-30 Emotional scale BSL 79 0.4630 81 1.000
M4 73 79
QLQ-30 Role scale BSL 71 0.0283 76 0.2713
M4 49 57
QLQ-30 Cognitive scale BSL 87 0.3009 85 0.5075
M4 75 80
QLQ-30 Nausea BSL 10 0.0009 10 0.4495
M4 25 16
QLQ-30 Pain BSL 29 0.0323 28 0.2089
M4 44 21
QLQ-30 Fatigue BSL 40 0.1129 35 0.4662
M4 56 48

Conclusions

For ABC patients, treatment with second-line ASC+mFOLFOX may allow stabilisation of QoL scales and avoid worsening of nausea and pain at 4 months after baseline assessment. Full analyses of QoL to explore this potentially positive impact of FOLFOX is ongoing, along with an assessment of whether FOLFOX may be cost-effective.

Clinical trial identification

NCT01926236.

Editorial acknowledgement

Legal entity responsible for the study

The Christie NHS Foundation Trust.

Funding

Cancer Research UK, StandUpToCancer, AMMF (The UK Cholangiocarcinoma Charity), and The Christie Charity, with additional funding from The Cholangiocarcinoma Foundation and the Conquer Cancer Foundation Young Investigator Award for translational research.

Disclosure

A. Lamarca: Financial Interests, Personal, Invited Speaker: Merck, Pfizer, Ipsen, Incyte, AAA, QED, QED, AstraZeneca, EISAI, Servier, Incyte; Financial Interests, Personal, Advisory Board: EISAI, Nutricia, Ipsen, QED, Roche, Servier, Boston Scientific, Albireo Pharma, AstraZeneca; Financial Interests, Institutional, Other, Access to FM molecular profiling: Roche; Non-Financial Interests, Principal Investigator, PI of trial: QED, Merck; Other, Other, Travel and educational support: Ipsen, Pfizer, Bayer, AAA, SIrTex, Novartis, Mylan, Delcath. All other authors have declared no conflicts of interest.

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