In a new research done by Hannah L Rush and colleagues, it was shown that during a 2-year period, patient-reported QOL was superior for patients assigned to receive AAP + SOC compared to docetaxel + SOC, narrowly missing the specified criterion for clinical significance. Throughout the first year after random assignment, patients who received AAP + SOC had clinically meaningfully higher global-QOL ratings. The findings of this study were published in the Journal of Clinical Oncology on 10th November, 2021.
When combined with standard of care (SOC) androgen deprivation treatment, docetaxel and abiraterone acetate plus prednisone or prednisolone (AAP) both increase survival in locally advanced or metastatic hormone-sensitive prostate cancer. As a result, data on patient-reported quality of life (QOL) may be used to inform treatment decisions.
For this study, the STAMPEDE experiment enrolled a group of patients at the same time, with the option of being randomly assigned to receive either docetaxel + SOC or AAP + SOC. A mixed-model evaluation of QOL was performed on participants who have completed at least one QLQ-C30 + PR25 questionnaire. The major outcome measure was the difference in global-QOL (QLQ-C30 Q29&30) between patients randomly assigned to docetaxel + SOC or AAP + SOC after 2 years, with a clinically relevant difference of > 4.0 points set as a predefined threshold. Secondary outcome variables included a comparison of functional domains, pain, and exhaustion, as well as global-QOL at predetermined time points.
The key findings of this study were:
1. A total of 515 patients (173 docetaxel + SOC and 342 AAP + SOC) were enrolled in the study.
2. Baseline features, missing data percentage, and mean baseline global-QOL ratings (docetaxel + SOC 77.8 and AAP + SOC 78.0) were comparable.
3. Over the two years following random assignment, the mean modelled global-QOL score in patients assigned to AAP + SOC was +3.9 points (95 percent CI, +0.5 to +7.2; P =.022) higher.
4. Over the first year, patients assigned to AAP + SOC had higher global-QOL (+5.7 points, 95 percent CI, +3.0 to +8.5; P.001), especially at 12 (+7.0 points, 95 percent CI, +3.0 to +11.0; P =.001) and 24 weeks (+8.3 points, 95 percent CI, +4.0 to +12.6; P.001).
In conclusion, the Authors found that Abiraterone acetate showed improved quality of life in patients.
Reference:
Rush HL, Murphy L, Morgans AK, Clarke NW, Cook AD, Attard G, Macnair A, Dearnaley DP, Parker CC, Russell JM, Gillessen S, Matheson D, Millman R, Brawley CD, Pugh C, Tanguay JS, Jones RJ, Wagstaff J, Rudman S, O'Sullivan JM, Gale J, Birtle A, Protheroe A, Gray E, Perna C, Tolan S, McPhail N, Malik ZI, Vengalil S, Fackrell D, Hoskin P, Sydes MR, Chowdhury S, Gilbert DC, Parmar MKB, James ND, Langley RE. Quality of Life in Men With Prostate Cancer Randomly Allocated to Receive Docetaxel or Abiraterone in the STAMPEDE Trial. J Clin Oncol. 2021 Nov 10:JCO2100728. doi:10.1200/JCO.21.00728.