Baseline quality of life as a prognostic survival tool in patients receiving sunitinib for metastatic renal cell carcinoma

David Cella*, A. G. Bushmakin, J. C. Cappelleri, C. Charbonneau, M. D. Michaelson, R. J. Motzer

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

BACKGROUND: In a randomized phase III trial of sunitinib vs interferon-alfa (IFN-α) in metastatic renal cell carcinoma (mRCC), better baseline quality of life (QoL) was predictive of longer survival. Using this dataset, we have developed a novel prognostic tool that establishes a relationship between baseline QoL scores and median survival time. METHODS: Baseline QoL was assessed using the FACT-Kidney Symptom Index-15 item (FKSI-15), its disease-related symptoms (FKSI-DRS) subscale, and the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Weibull models estimated median progression-free survival (mPFS) and overall survival (mOS) as a function of baseline QoL. RESULTS: Longer PFS and OS were associated with higher baseline FKSI-15, FKSI-DRS, and FACT-G scores (P<0.05), and baseline FKSI-15 score was the best predictor of survival. For example, for a baseline FKSI-15 score of 60, the predicted mPFS was 67.9 weeks, and predicted mOS was 240.6 weeks. The magnitude of benefit was greater with sunitinib vs IFN-α for a given baseline QoL score. CONCLUSION: This novel tool indicates that baseline FKSI-15 scores were linked to mPFS and mOS in a clear and interpretable way. The results support evaluation of patient-reported QoL symptoms at baseline as a prognostic indicator of survival in clinical research and practice.

Original languageEnglish (US)
Pages (from-to)646-650
Number of pages5
JournalBritish Journal of Cancer
Volume106
Issue number4
DOIs
StatePublished - Feb 14 2012

Keywords

  • Weibull model
  • metastatic renal cell carcinoma
  • prognostic tool
  • quality of life
  • sunitinib
  • survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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