Quality of life maintained during mRCC TKI therapy

By Laura Cowen, medwireNews Reporter

Treatment with tyrosine kinase inhibitors (TKIs) does not appear to significantly impair health-related quality of life (HRQoL) in Japanese patients with metastatic renal cell carcinoma (mRCC), say researchers.

This is despite the fact that both the incidence and severity of adverse events associated with the use of molecular-targeted agents for mRCC has been reported to be higher in Japanese than in Western populations, remark Hideaki Miyake (Kobe University Graduate School of Medicine, Japan) and colleagues.

The study included 240 Japanese mRCC patients who completed a total of 305 surveys assessing their HRQoL before and 3 months after the introduction of first- or second-line molecular-targeted therapy with TKIs. These including 150, 95 and 60 questionnaires that were completed during treatment with sunitinib, sorafenib and axitinib, respectively.

The survey used was the Japanese version of the Medical Outcomes Study 36-Item Short Form (SF-36), which quantifies HRQoL with eight multi-item scales measuring mental as well as physical health.

As reported in Medical Oncology, there were no significant differences in any of the eight scale scores between the surveys conducted before and 3 months after initiation of TKI treatment. However, all scores were significantly lower than those of an age-matched control population in Japan both before and during TKI therapy.

When the researchers compared the impact of each individual TKI on HRQoL, they found that the scores for general health perception and mental health were significantly higher during axitinib treatment than during sorafenib treatment, but no other differences were observed.

Multivariate analyses revealed that therapeutic efficacy was the only independent variable that had an impact on general health perception and mental health. Age, gender, type of TKI, timing of TKI introduction and severity of adverse events did not affect these or any of the other outcomes assessed by the SF-36 survey.

Taken together with results from other studies, the researchers say that their findings “suggest that the introduction of molecular-targeted agents could maintain the QOL status in mRCC patients without significant impairment”, particularly in those “achieving a satisfactory therapeutic outcome”.

However, Miyake et al also caution that inclusion of only Japanese patients means the results cannot be applied to all patients receiving TKIs.

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