title: Quality of life assessment in patients with metastatic colorectal cancer receiving maintenance therapy after first-line induction treatment: a preplanned analysis of the phase III AIO KRK 0207 trial.
abstract: First-line maintenance strategies are a current matter of debate in the management of mCRC. Their impact on patient's health-related quality of life (HRQOL) has not yet been evaluated. The objective of this study was to assess whether differences in HRQOL during any active maintenance treatment compared with no maintenance treatment exist.
  
  
  
  Eight hundred and thirty-seven patients were enrolled in the AIO KRK 0207 trial. Four hundred and seventy-two underwent randomization (after 24 weeks of induction treatment) into one of the maintenance arms: FP plus Bev (arm A), Bev alone (arm B), or no active treatment (arm C). HRQOL were assessed every 6 weeks during induction and maintenance treatment independent from treatment stop, delay, or modification, and also continued after progression, using the EORTC QLQ-C30, QLQ-CR29. The mean value of the global quality of life dimension (GHS/QoL) of the EORTC QLQ-C30, calculated as the average of all available time points after randomization was considered as pre-specified main endpoint. Additionally, EORTC QLQ-C30 response scores were analyzed.
  
  
  
  For HRQOL analysis, 413 patients were eligible (arm A: 136; arm B: 142, arm C: 135). Compliance rate with the HRQOL questionnaires was 95% at time of randomization and remained high during maintenance (98%, 99%, 97% and 97% at week 6, 12, 18 and 24). No significant differences between treatment arms in the mean GHS/QoL scores were observed at any time point. Also, rates of GHS/QoL score deterioration were similar (20.5%; 17.2% and 20.7% of patients), whereas a score improvement occurred in 36.1%; 43.8% and 42.1% (arms A, B and C).
  
  
  
  Continuation of an active maintenance treatment with FP/Bev after induction treatment was neither associated with a detrimental effect on GHS/QoL scores when compared with both, less active treatment with Bev alone or no active treatment.
  
  
  
  NCT00973609 (ClinicalTrials.gov).
authors.affiliation: Department of Oncology, Haematology, Bone Marrow Transplantation with Section Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg j.quidde@uke.de.
authors.forename: J
authors.initials: J
authors.lastname: Quidde
authors.affiliation: HOPE-Practice for Oncology, Hamburg.
authors.forename: S
authors.initials: S
authors.lastname: Hegewisch-Becker
authors.affiliation: Department of Hematology, Oncology and Gastroenterology, Kliniken Maria Hilf GmbH, Mönchengladbach.
authors.forename: U
authors.initials: U
authors.lastname: Graeven
authors.affiliation: Practice for Oncology, Münster.
authors.forename: C A
authors.initials: CA
authors.lastname: Lerchenmüller
authors.affiliation: Department of Hematology/Oncology, Lahn-Dill-Kliniken, Wetzlar.
authors.forename: B
authors.initials: B
authors.lastname: Killing
authors.affiliation: Practice for Oncology, Gütersloh.
authors.forename: R
authors.initials: R
authors.lastname: Depenbusch
authors.affiliation: MVZ Hematology/Oncology, Stade.
authors.forename: C-C
authors.initials: CC
authors.lastname: Steffens
authors.affiliation: Department for Hematology/Oncology, Asklepios Klinikum Weissenfels, Weissenfels.
authors.forename: T
authors.initials: T
authors.lastname: Lange
authors.affiliation: Department of Gastroenterology/Hematology/Oncology, Klinikum Bietigheim, Bietigheim-Bissingen.
authors.forename: G
authors.initials: G
authors.lastname: Dietrich
authors.affiliation: Institut für Tumorgenetik, Bonn.
authors.forename: J
authors.initials: J
authors.lastname: Stoehlmacher
authors.affiliation: Medical Department, Ruhr-University, Bochum.
authors.forename: A
authors.initials: A
authors.lastname: Reinacher
authors.affiliation: Institute for Pathology, Ruhr-University, Bochum.
authors.forename: A
authors.initials: A
authors.lastname: Tannapfel
authors.affiliation: iOMEDICO AG, Freiburg.
authors.forename: T
authors.initials: T
authors.lastname: Trarbach
authors.affiliation: iOMEDICO AG, Freiburg.
authors.forename: N
authors.initials: N
authors.lastname: Marschner
authors.affiliation: Department of Hematology and Oncology, University Hospital Halle (Saale), Halle.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Schmoll
authors.affiliation: Department of Cancer Research, CCRC, Düsseldorf.
authors.forename: A
authors.initials: A
authors.lastname: Hinke
authors.affiliation: UCT University Cancer Center, Krankenhaus Nordwest, Frankfurt, Germany.
authors.forename: S-E
authors.initials: SE
authors.lastname: Al-Batran
authors.affiliation: Department, Oncology, Instituto CUF de Oncologia (ICO), Lisbon, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Arnold
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: colorectal cancer; maintenance treatment; quality of life