2017
Health-related quality of life for everolimus versus placebo in patients with advanced, non-functional, well-differentiated gastrointestinal or lung neuroendocrine tumours (RADIANT-4): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
PAVEL, M.E., S. SINGH, J.R. STROSBERG, L. BUBUTEISHVILI-PACAUD, E. DEGTYAREV et. al.Základní údaje
Originální název
Health-related quality of life for everolimus versus placebo in patients with advanced, non-functional, well-differentiated gastrointestinal or lung neuroendocrine tumours (RADIANT-4): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial
Autoři
PAVEL, M.E. (276 Německo), S. SINGH (124 Kanada), J.R. STROSBERG (840 Spojené státy), L. BUBUTEISHVILI-PACAUD (756 Švýcarsko), E. DEGTYAREV (756 Švýcarsko), M.P. NEARY (840 Spojené státy), C. CARNAGHI (380 Itálie), Jiří TOMÁŠEK (203 Česká republika, garant, domácí), E. WOLIN (840 Spojené státy), M. RADERER (40 Rakousko), H. LAHNER (276 Německo), J.W. VALLE (826 Velká Británie a Severní Irsko), R. POMMIER (840 Spojené státy), E. VAN CUTSEM (56 Belgie), M.E.T. TESSELAAR (528 Nizozemské království), G. DELLE FAVE (380 Itálie), R. BUZZONI (380 Itálie), M. HUNGER (276 Německo), J. ERIKSSON (752 Švédsko), D. CELLA (840 Spojené státy), J.F. RICCI (756 Švýcarsko), N. FAZIO (380 Itálie), M.H. KULKE (840 Spojené státy) a J.C. YAO (840 Spojené státy)
Vydání
Lancet Oncology, New York, Elsevier Science INC, 2017, 1470-2045
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30204 Oncology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 36.421
Kód RIV
RIV/00216224:14110/17:00099925
Organizační jednotka
Lékařská fakulta
UT WoS
000411843500056
Klíčová slova anglicky
RADIANT-4; everolimus versus placebo
Štítky
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 20. 3. 2018 17:06, Soňa Böhmová
Anotace
V originále
Background In the phase 3 RADIANT-4 trial, everolimus increased progression-free survival compared with placebo in patients with advanced, progressive, non-functional, well-differentiated gastrointestinal or lung neuroendocrine tumours (NETs). We now report the health-related quality of life (HRQOL) secondary endpoint. Methods RADIANT-4 is a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial done in 97 centres in 25 countries worldwide. Adults (aged >= 18 years) were eligible for the study if they had pathologically confirmed, advanced (unresectable or metastatic), non-functional, well-differentiated (grade 1 or 2) NETs of lung or gastrointestinal origin. Patients were randomly allocated (2:1) using block randomisation (block size of three) by an interactive voice response system to receive oral everolimus (10 mg per day) or placebo, both with best supportive care, with stratification by tumour origin, WHO performance status, and previous somatostatin analogue treatment. HRQOL was assessed with the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire at baseline (visit 2, day 1), every 8 weeks (+/- 1 week) during the study for the first 12 months after randomisation, and every 12 weeks thereafter until study drug discontinuation. The primary endpoint, reported previously, was progression-free survival assessed by central review; HRQOL was a prespecified secondary endpoint. The prespecified secondary outcome measure was time to definitive deterioration (>= 7 points) in FACT-G total score. Analyses were done on the full analysis set, consisting of all randomised patients, by intention to treat. Only data obtained while receiving the randomly allocated treatment were included in this analysis. Enrolment for RADIANT-4 was completed on Aug 23, 2013, but the trial is ongoing pending final analysis of the key secondary endpoint of overall survival. This trial is registered with ClinicalTrials.gov, number NCT01524783. Findings Between April 3, 2012, and Aug 23, 2013, 302 patients were enrolled; 205 were randomly allocated everolimus and 97 were assigned placebo. At baseline, 193 (94%) of 205 patients assigned everolimus and 95 (98%) of 97 allocated placebo had completed either fully or partly the FACT-G questionnaire; at week 48, 70 (83%) of 84 patients assigned everolimus and 22 (85%) of 26 allocated placebo completed FACT-G. Median time to definitive deterioration in FACT-G total score was 11 . 27 months (95% CI 9 . 27-19 . 35) with everolimus and 9 . 23 months (5 . 52-not estimable) with placebo (adjusted hazard ratio 0 . 81, 95% CI 0 . 55-1 . 21; log-rank p=0 . 31). Interpretation HRQOL was maintained for patients with advanced, non-functional, gastrointestinal or lung NETs, with no relevant differences noted between the everolimus and placebo groups. In view of the previous RADIANT-4 findings of longer progression-free survival with everolimus, our findings suggest that everolimus delays disease progression while preserving overall HRQOL, even with the usual toxic effects related to active targeted drug treatment for cancer.