title: Pre-treatment global quality of health predicts progression free survival in metastatic kidney cancer patients treated with sorafenib or sunitinib.
abstract: OBJECTIVE
  Our goal was to prospectively evaluate self-reported quality-of-life (QoL) during second-line therapy in 51 consecutive patients with cytokine-refractory kidney cancer treated with sorafenib or sunitinib.
  
  
  METHODS
  QoL was assessed by the EORTC QoL questionnaire QLQ-C30 at baseline and at weeks 4, 6, 10, 12 and 16.
  
  
  RESULTS
  Global QoL deteriorated significantly during the first 4 weeks of treatment (P < 0.0001). Patients experienced a reduction of their role, cognitive, and social function (all P < 0.0001). In addition, fatigue (P < 0.0001), nausea/vomiting (P = 0.003), and pain (P < 0.0001) as well as dyspnoea (P < 0.0001), insomnia (P = 0.026), appetite loss (P = 0.013), and diarrhoea (P < 0.0001) increased significantly. After 16 weeks, fatigue (P < 0.0001), pain (P = 0.015), appetite loss (P = 0.002) and diarrhoea (P = 0.038) were still influenced by the therapy, while all functional scales recovered. Global QoL at baseline was predictive of overall response (P = 0.006) and progression free survival (PFS) (P < 0.0001). A better physical function at baseline, a better ECOG performance status, and a low risk profile according to MSKCC risk groups correlated with a longer PFS (all P < 0.0001). No significant differences regarding QoL were found between sorafenib and sunitinib during the study period.
  
  
  CONCLUSIONS
  Second-line therapy with sorafenib or sunitinib does not adversely affect patients global QoL after 16 weeks of treatment. Evaluation of baseline QoL can help to further stratify patients into risk groups predicting overall response and PFS.
authors.affiliation: Department of Urology, University of Münster, Albert-Schweitzer Str. 33, 48149, Munster, Germany. herrmae@ukmuenster.de
authors.forename: Edwin
authors.initials: E
authors.lastname: Herrmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Gerss
authors.forename: Stefan
authors.initials: S
authors.lastname: Bierer
authors.forename: Thomas
authors.initials: T
authors.lastname: Köpke
authors.forename: Christian
authors.initials: C
authors.lastname: Bolenz
authors.forename: Lothar
authors.initials: L
authors.lastname: Hertle
authors.forename: Christian
authors.initials: C
authors.lastname: Wülfing
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D006306:Health Surveys; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives; D010166:Palliative Care; D010671:Phenylurea Compounds; D011379:Prognosis; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D011788:Quality of Life; D016879:Salvage Therapy; D000077157:Sorafenib; D000077210:Sunitinib; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D007211:Indoles; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; D009536:Niacinamide; D000077157:Sorafenib; D000077210:Sunitinib