Quality of Life During Treatment With Chemohormonal Therapy: Analysis of E3805 Chemohormonal Androgen Ablation Randomized Trial in Prostate Cancer

Purpose Chemohormonal therapy with docetaxel and androgen deprivation therapy (ADT+D) for metastatic hormone-sensitive prostate cancer improves overall survival as compared with androgen deprivation therapy (ADT) alone. We compared the quality of life (QOL) between patients with metastatic hormone-sensitive prostate cancer who were treated with ADT+D and those who were treated with ADT alone. Methods Men were randomly assigned to ADT+ D (six cycles) or to ADT alone. QOL was assessed by Functional Assessment of Cancer Therapy-Prostate (FACT-P), FACT-Taxane, Functional Assessment of Chronic Illness Therapy-Fatigue, and the Brief Pain Inventory at baseline and at 3, 6, 9, and 12 months. The Wilcoxon signed rank test was used to examine changes over time. Mixed-effect models compared the QOL between arms at each time point. Results Seven hundred ninety men were randomly assigned (ADT+D [n = 397] and ADT[ n = 393]) and completed FACT-P (90% at baseline, 86% at 3 months, 83% at 6 months, 78% at 9 months, and 77% at 12 months). ADT+D patients reported a statistically significant decline in FACT-P at 3 months ( P < .001) but FACT-P did not differ significantly between baseline and 12 months ( P = .38). ADT+D FACT-P scores were significantly lower at 3 months ( P = .02) but significantly higher at 12 months ( P = .04) when compared with ADT FACT-P scores. Differences did not exceed the minimal clinically important difference at any time point. ADT+D patients reported significantly lower Functional Assessment of Chronic Illness Therapy-Fatigue scores at 3 months than did ADT patients ( P < .001). Over time, both arms reported significantly poorer FACT-Taxane scores ( P < .001) when compared with baseline. Brief Pain Inventory scores were similar between arms. Conclusion Although ADT+D was associated with statistically worse QOL at 3 months, QOL was better at 12 months for ADT+D patients than for ADT patients. Both arms reported a similar minimally changed QOL over time, suggesting that ADT+D is not associated with a greater long-term negative impact on QOL.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2018 Mar 09 [Epub ahead of print]

Alicia K Morgans, Yu-Hui Chen, Christopher J Sweeney, David F Jarrard, Elizabeth R Plimack, Benjamin A Gartrell, Michael A Carducci, Maha Hussain, Jorge A Garcia, David Cella, Robert S DiPaola, Linda J Patrick-Miller

Alicia K. Morgans, Maha Hussain, and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Yu-Hui Chen and Christopher J. Sweeney, Dana Farber Cancer Institute, Boston, MA; David F. Jarrard, University of Wisconsin Hospital and Clinics, Madison, WI; Elizabeth R. Plimack, Fox Chase Cancer Center, Philadelphia, PA; Elizabeth R. Plimack and Benjamin A. Gartrell, Montefiore Medical Center, Bronx, NY; Michael A. Carducci, Johns Hopkins University, Baltimore, MD; Jorge A. Garcia, Cleveland Clinic, Cleveland, OH; Robert S. DiPaola, University of Kentucky College of Medicine, Lexington, KY; and Linda J. Patrick-Miller, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.