Abstract
Background: Patients with metastatic pancreatic cancer often have a detriment in health-related quality of life (HRQoL). In the randomized, double-blind, phase III POLO trial progression-free survival was significantly longer with maintenance olaparib, a poly(ADP-ribose) polymerase inhibitor, than placebo in patients with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and metastatic pancreatic cancer whose disease had not progressed during first-line platinum-based chemotherapy. The prespecified HRQoL evaluation is reported here. Patients and methods: Patients were randomized to receive maintenance olaparib (300 mg b.i.d.; tablets) or placebo. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item module at baseline, every 4 weeks until disease progression, at discontinuation, and 30 days after last dose. Scores ranged from 0 to 100; a ≥10-point change or difference between arms was considered clinically meaningful. Adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TSCMD) was analysed using a log-rank test. Results: Of 154 randomized patients, 89 of 92 olaparib-arm and 58 of 62 placebo-arm patients were included in HRQoL analyses. The adjusted mean change in Global Health Status (GHS) score from baseline was <10 points in both arms and there was no significant between-group difference [-2.47; 95% confidence interval (CI) -7.27, 2.33; P = 0.31]. Analysis of physical functioning scores showed a significant between-group difference (-4.45 points; 95% CI -8.75, -0.16; P = 0.04). There was no difference in TSCMD for olaparib versus placebo for GHS [P = 0.25; hazard ratio (HR) 0.72; 95% CI 0.41, 1.27] or physical functioning (P = 0.32; HR 1.38; 95% CI 0.73, 2.63). Conclusions: HRQoL was preserved with maintenance olaparib treatment with no clinically meaningful difference compared with placebo. These results support the observed efficacy benefit of maintenance olaparib in patients with a gBRCAm and metastatic pancreatic cancer. ClincalTrials.gov number: NCT02184195.
Original language | English (US) |
---|---|
Pages (from-to) | 1959-1968 |
Number of pages | 10 |
Journal | Annals of Oncology |
Volume | 30 |
Issue number | 12 |
DOIs | |
State | Published - Dec 1 2019 |
Keywords
- BRCA
- health-related quality of life
- metastatic
- olaparib
- pancreatic cancer
ASJC Scopus subject areas
- Hematology
- Oncology
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Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib. / Hammel, P.; Kindler, H. L.; Reni, M.; Van Cutsem, E.; MacArulla, T.; Hall, M. J.; Park, J. O.; Hochhauser, D.; Arnold, D.; Oh, D. Y.; Reinacher-Schick, Anke; Tortora, Giampaolo; Algül, H.; O'Reilly, E. M.; McGuinness, D.; Cui, K. Y.; Joo, S.; Yoo, H. K.; Patel, N.; Golan, T.; Chantrill, Lorraine; Goldstein, David; Joubert, Warren; Pavlakis, Nick; Tognela, Annette; Van Cutsem, Eric; Van Fraeyenhove, Frank; Van Laethem, Jean Luc; Peeters, Marc; Dhani, Neesha; Kavan, Petr; Lemay, Frederic; Adenis, Antoine; Artru, Pascal; Baba-Hamed, Nabil; Belletier, Christine; Ben Abdelghani, Meher; Blanc, Jean Frederic; Borg, Christophe; Coriat, Romain; Deplanque, Gael; Faroux, Roger; Follana, Philippe; Guimbaud, Rosine; El Hajbi, Farid; Hammel, Pascal; Hautefeuille, Vincent; Malka, David; Metges, Jean Philippe; Tougeron, David; Walter, Thomas; Algül, Hana; Ettrich, Thomas; Hacker, Ulrich Thorsten; Hennes, Elke; Jacobasch, Lutz; Kanzler, Stephan; Pession, Ursula; Scholz, Christian; Sinn, Marianne; Stein, Alexander; Strassburg, Christian; Vogel, Arndt; Ben-Shahar, Menachem; Brenner, Ronen; Epelbaum, Ron; Geva, Ravit; Gluzman, Alexander; Golan, Talia; Idelevich, Efraim; Kolin, Maya; Semenisty, Valeriya; Shai, Ayelet; Stemmer, Salomon; Yarom, Nirit; Celio, Luigi; Conte, Pierfranco; Garufi, Carlo; Gianni, Luca; Leonardi, Francesco; Maiello, Evaristo; Di Marco, Mariacristina; Milella, Michele; Pinto, Carmine; Santini, Daniele; Scartozzi, Mario; Vaccaro, Vanja; Vasile, Enrico; Kim, Ji Won; Kim, Jin Won; Oh, Do Youn; Oh Park, Joon; Wilmink, Hanneke; Gallego, Rafael Alvarez; Ogalla, Gema Duran; Velasco, Adelaida Garcia; Cabanas, Elena Garralda; Gomez Martin, Carlos; Ponce, Carmen Guillén; Saez, Berta Laquente; Lopez, Rafael; MacArulla, Teresa; Martin, Andres Munoz; Pazo, Roberto; Pijaume, Carles Pericay; Rodriguez, Javier; Yaya-Tur, Ricardo; Arora, Arvind; Anthoney, David Alan; Jeffrey Evans, T. R.; Harrison, Mark; Hochhauser, Daniel; Palmer, Daniel; Sarker, Debashis; Starling, Naureen; Valle, Juan; Wall, Lucy; Agajanian, Richy; Bearden, James; Bekaii-Saab, Tanios; Carter, Corey; Cohen, Deirdre; Distefano, Alfred; Dragovich, Tomislav; Ejadi, Samuel; Ford, James; Grabelsky, Stephen; Hall, Michael; Hochster, Howard; Hosein, Peter; Javle, Milind; Kindler, Hedy; Lacy, Jill; Laheru, Daniel; Leong, Stephen; Lowery, Maeve; Marsh, Robert; Noonan, Anne; Oberstein, Paul; Ocean, Allyson; O'Reilly, Eileen; Ryan, David; Seery, Tara; Subramaniam, Somasundaram; Van Echo, David; Wang-Gillam, Andrea; Weekes, Colin; Welch, Stephen.
In: Annals of Oncology, Vol. 30, No. 12, 01.12.2019, p. 1959-1968.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib
AU - Hammel, P.
AU - Kindler, H. L.
AU - Reni, M.
AU - Van Cutsem, E.
AU - MacArulla, T.
AU - Hall, M. J.
AU - Park, J. O.
AU - Hochhauser, D.
AU - Arnold, D.
AU - Oh, D. Y.
AU - Reinacher-Schick, Anke
AU - Tortora, Giampaolo
AU - Algül, H.
AU - O'Reilly, E. M.
AU - McGuinness, D.
AU - Cui, K. Y.
AU - Joo, S.
AU - Yoo, H. K.
AU - Patel, N.
AU - Golan, T.
AU - Chantrill, Lorraine
AU - Goldstein, David
AU - Joubert, Warren
AU - Pavlakis, Nick
AU - Tognela, Annette
AU - Van Cutsem, Eric
AU - Van Fraeyenhove, Frank
AU - Van Laethem, Jean Luc
AU - Peeters, Marc
AU - Dhani, Neesha
AU - Kavan, Petr
AU - Lemay, Frederic
AU - Adenis, Antoine
AU - Artru, Pascal
AU - Baba-Hamed, Nabil
AU - Belletier, Christine
AU - Ben Abdelghani, Meher
AU - Blanc, Jean Frederic
AU - Borg, Christophe
AU - Coriat, Romain
AU - Deplanque, Gael
AU - Faroux, Roger
AU - Follana, Philippe
AU - Guimbaud, Rosine
AU - El Hajbi, Farid
AU - Hammel, Pascal
AU - Hautefeuille, Vincent
AU - Malka, David
AU - Metges, Jean Philippe
AU - Tougeron, David
AU - Walter, Thomas
AU - Algül, Hana
AU - Ettrich, Thomas
AU - Hacker, Ulrich Thorsten
AU - Hennes, Elke
AU - Jacobasch, Lutz
AU - Kanzler, Stephan
AU - Pession, Ursula
AU - Scholz, Christian
AU - Sinn, Marianne
AU - Stein, Alexander
AU - Strassburg, Christian
AU - Vogel, Arndt
AU - Ben-Shahar, Menachem
AU - Brenner, Ronen
AU - Epelbaum, Ron
AU - Geva, Ravit
AU - Gluzman, Alexander
AU - Golan, Talia
AU - Idelevich, Efraim
AU - Kolin, Maya
AU - Semenisty, Valeriya
AU - Shai, Ayelet
AU - Stemmer, Salomon
AU - Yarom, Nirit
AU - Celio, Luigi
AU - Conte, Pierfranco
AU - Garufi, Carlo
AU - Gianni, Luca
AU - Leonardi, Francesco
AU - Maiello, Evaristo
AU - Di Marco, Mariacristina
AU - Milella, Michele
AU - Pinto, Carmine
AU - Santini, Daniele
AU - Scartozzi, Mario
AU - Vaccaro, Vanja
AU - Vasile, Enrico
AU - Kim, Ji Won
AU - Kim, Jin Won
AU - Oh, Do Youn
AU - Oh Park, Joon
AU - Wilmink, Hanneke
AU - Gallego, Rafael Alvarez
AU - Ogalla, Gema Duran
AU - Velasco, Adelaida Garcia
AU - Cabanas, Elena Garralda
AU - Gomez Martin, Carlos
AU - Ponce, Carmen Guillén
AU - Saez, Berta Laquente
AU - Lopez, Rafael
AU - MacArulla, Teresa
AU - Martin, Andres Munoz
AU - Pazo, Roberto
AU - Pijaume, Carles Pericay
AU - Rodriguez, Javier
AU - Yaya-Tur, Ricardo
AU - Arora, Arvind
AU - Anthoney, David Alan
AU - Jeffrey Evans, T. R.
AU - Harrison, Mark
AU - Hochhauser, Daniel
AU - Palmer, Daniel
AU - Sarker, Debashis
AU - Starling, Naureen
AU - Valle, Juan
AU - Wall, Lucy
AU - Agajanian, Richy
AU - Bearden, James
AU - Bekaii-Saab, Tanios
AU - Carter, Corey
AU - Cohen, Deirdre
AU - Distefano, Alfred
AU - Dragovich, Tomislav
AU - Ejadi, Samuel
AU - Ford, James
AU - Grabelsky, Stephen
AU - Hall, Michael
AU - Hochster, Howard
AU - Hosein, Peter
AU - Javle, Milind
AU - Kindler, Hedy
AU - Lacy, Jill
AU - Laheru, Daniel
AU - Leong, Stephen
AU - Lowery, Maeve
AU - Marsh, Robert
AU - Noonan, Anne
AU - Oberstein, Paul
AU - Ocean, Allyson
AU - O'Reilly, Eileen
AU - Ryan, David
AU - Seery, Tara
AU - Subramaniam, Somasundaram
AU - Van Echo, David
AU - Wang-Gillam, Andrea
AU - Weekes, Colin
AU - Welch, Stephen
N1 - Funding Information: PH reports grants received from AstraZeneca during the conduct of this study. Personal fees and grants from Celgene, Erythec, Halozyme, Novartis, Pfizer and Servier outside of the submitted work. HLK reports grants and personal fees from AstraZeneca during the conduct of this study. Personal fees from Aldeyra Therapuetics, Astellas, Erytech, Five Prime Therapeutics, Ipsen Pharmaceuticals, and Kyowa. Personal fees and non-financial support from Boehringer-Ingelheim and Paredox Therapeutics. Grants and personal fees from Bristol-Myers Squibb and MedImmune. Grants from Aduro, Bayer, Deciphera, Glaxo Smith Kline, Lilly, Polaris, and Verastem. Grants, personal fees and non-financial support from Merck outside the submitted work. MR reports grants, personal fees and non-financial support from Celgene, personal fees from Baxalta, Eli Lilly, Pfizer, Novocure, Novartis, Shire and AstraZeneca and unpaid Steering Committee membership for Boston Pharmaceuticals, outside the submitted work. EvC reports grants from Amgen, Boehringer Ingelheim, Ipsen and Roche; grants and personal fees from Bayer, Celgene, Lilly, Merck Sharp & Dohme, Merck KGaA, Novartis, Roche and Servier; personal fees from AstraZeneca, and Bristol-Myers Squibb outside the submitted work. TM reports personal fees and non-financial support from Shire Pharmaceuticals, Servier, Sanofi, Celgene, Incyte, and H3 Biomedicine; personal fees from Roche, Baxter, QED Therapeutics and Amgen; grants from BeiGene; grants and personal fees from AstraZeneca outside the submitted work. MJH reports non-financial support and research collaboration only from Myriad Genetic Laboratories, Caris Life Science, Foundation Medicine, Invitae, and Ambry; non-financial support from Astra-Zeneca, outside the submitted work. JOP reports grants and personal fees from Celgene, personal fees from Shire/Servier, Merck Serono, and Sanofi, outside the submitted work. DA reports personal fees from AstraZeneca during the conduct of the study; personal fees and non-financial support from Bayer, BMS, MSD, Servier, Sanofi, Roche, and Sirtex; personal fees from Biocompatibles, Eli Lilly, and Terumo outside the submitted work. D-YO reports grants from AstraZeneca, personal fees from Novartis, Genentech/Roche, Merck Serono, Bayer, Taiho, ASLAN, and Halozyme, outside the submitted work. AR-S reports grants from AstraZeneca during the conduct of the study; grants, personal fees and nonfinancial support from Amgen, Celgene, Roche, and Servier; personal fees from Baxalta, BMS, MSD, Pfizer, Sanofi-Aventis, Shire, iomedico, Aurikamed, MCI, med publico, BSH, Promedicis, and BOVita; grants and non-financial support from Ipsen; grants and personal fees from Lilly, and Merck Serono; grants from AIO Studien gGmbH, Mologen Berlin, Boehringer, Pharma Consulting Group AB Sweden, and Syneed medidata GmbH outside the submitted work. GT reports personal fees from Celgene outside the submitted work. HA reports personal fees from Servier and Celgene; grants from Chugai; nonfinancial support from Lilly and Revolution Medicine outside the submitted work. EMO’R reports grants and personal fees from AstraZeneca, grants from NCI, personal fees from Merck, during the conduct of the study; grants from ActaBiologica, Array, Genentech, MabVax, Novartis, OncoQuest, Polaris Puma, QED, and Roche; grants and personal fees from Agios, AstraZeneca, Bayer, Beigene, from BMS, Casi, Celgene, Exelixis, Halozyme, Incyte, and Lilly; personal fees from 3DMed, AlignMed, Amgen, Antengene, Aptus, Aslan, Astellas, Bioline, Boston Scientific, BridgeBio, CARsgen, Cipla, CytomX, Daiichi, Debiopharm, Delcath, Eisai, Genoscience, Hengrui, Inovio, Ipsen, Jazz, Janssen, Kyowa Kirin, LAM, Loxo, Merck, Mina, Novella, Onxeo, PCI Biotech, Pfizer, Pieris, RedHill, Sanofi, Servier, Silsenseed, SillaJen, Sobi, Targovax, Tekmira, TwoXAR, Vicus, Yakult, and Yiviva outside the submitted work. DH and DMcG have declared no conflicts of interest. KYC reports other funding from Merck & Co., Inc associated with the conduct of the study. SJ is an employee of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA and owns stock in Merck & Co., Inc., Kenilworth, NJ, USA. HKY is an employee of AstraZeneca. NP is an employee of AstraZeneca and owns stock. TG reports personal fees from AstraZeneca during the conduct of the study; institutional research funding from AstraZeneca, and Merck MSD, consultancy fees from AstraZeneca, AbbVie, Bayer, Merck MSD and Teva, and has participated in speakers’ bureaus for AbbVie outside the submitted work. Funding Information: This study was sponsored by AstraZeneca and is part of an alliance between AstraZeneca and MSD (no grant number). This research was funded in part through the NIH/NCI Cancer Center Support Grant P30-17 CA008748. Funding Information: We thank the patients who participated in this trial, their families and our co-investigators. Medical writing assistance was provided by Elin Pyke, MChem, from Mudskipper Business Ltd, funded by AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA (MSD).
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: Patients with metastatic pancreatic cancer often have a detriment in health-related quality of life (HRQoL). In the randomized, double-blind, phase III POLO trial progression-free survival was significantly longer with maintenance olaparib, a poly(ADP-ribose) polymerase inhibitor, than placebo in patients with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and metastatic pancreatic cancer whose disease had not progressed during first-line platinum-based chemotherapy. The prespecified HRQoL evaluation is reported here. Patients and methods: Patients were randomized to receive maintenance olaparib (300 mg b.i.d.; tablets) or placebo. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item module at baseline, every 4 weeks until disease progression, at discontinuation, and 30 days after last dose. Scores ranged from 0 to 100; a ≥10-point change or difference between arms was considered clinically meaningful. Adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TSCMD) was analysed using a log-rank test. Results: Of 154 randomized patients, 89 of 92 olaparib-arm and 58 of 62 placebo-arm patients were included in HRQoL analyses. The adjusted mean change in Global Health Status (GHS) score from baseline was <10 points in both arms and there was no significant between-group difference [-2.47; 95% confidence interval (CI) -7.27, 2.33; P = 0.31]. Analysis of physical functioning scores showed a significant between-group difference (-4.45 points; 95% CI -8.75, -0.16; P = 0.04). There was no difference in TSCMD for olaparib versus placebo for GHS [P = 0.25; hazard ratio (HR) 0.72; 95% CI 0.41, 1.27] or physical functioning (P = 0.32; HR 1.38; 95% CI 0.73, 2.63). Conclusions: HRQoL was preserved with maintenance olaparib treatment with no clinically meaningful difference compared with placebo. These results support the observed efficacy benefit of maintenance olaparib in patients with a gBRCAm and metastatic pancreatic cancer. ClincalTrials.gov number: NCT02184195.
AB - Background: Patients with metastatic pancreatic cancer often have a detriment in health-related quality of life (HRQoL). In the randomized, double-blind, phase III POLO trial progression-free survival was significantly longer with maintenance olaparib, a poly(ADP-ribose) polymerase inhibitor, than placebo in patients with a germline BRCA1 and/or BRCA2 mutation (gBRCAm) and metastatic pancreatic cancer whose disease had not progressed during first-line platinum-based chemotherapy. The prespecified HRQoL evaluation is reported here. Patients and methods: Patients were randomized to receive maintenance olaparib (300 mg b.i.d.; tablets) or placebo. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item module at baseline, every 4 weeks until disease progression, at discontinuation, and 30 days after last dose. Scores ranged from 0 to 100; a ≥10-point change or difference between arms was considered clinically meaningful. Adjusted mean change from baseline was analysed using a mixed model for repeated measures. Time to sustained clinically meaningful deterioration (TSCMD) was analysed using a log-rank test. Results: Of 154 randomized patients, 89 of 92 olaparib-arm and 58 of 62 placebo-arm patients were included in HRQoL analyses. The adjusted mean change in Global Health Status (GHS) score from baseline was <10 points in both arms and there was no significant between-group difference [-2.47; 95% confidence interval (CI) -7.27, 2.33; P = 0.31]. Analysis of physical functioning scores showed a significant between-group difference (-4.45 points; 95% CI -8.75, -0.16; P = 0.04). There was no difference in TSCMD for olaparib versus placebo for GHS [P = 0.25; hazard ratio (HR) 0.72; 95% CI 0.41, 1.27] or physical functioning (P = 0.32; HR 1.38; 95% CI 0.73, 2.63). Conclusions: HRQoL was preserved with maintenance olaparib treatment with no clinically meaningful difference compared with placebo. These results support the observed efficacy benefit of maintenance olaparib in patients with a gBRCAm and metastatic pancreatic cancer. ClincalTrials.gov number: NCT02184195.
KW - BRCA
KW - health-related quality of life
KW - metastatic
KW - olaparib
KW - pancreatic cancer
UR - http://www.scopus.com/inward/record.url?scp=85077402748&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077402748&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdz406
DO - 10.1093/annonc/mdz406
M3 - Article
C2 - 31562758
AN - SCOPUS:85077402748
VL - 30
SP - 1959
EP - 1968
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 12
ER -