Targeted Drug Combos Help Maintain Quality of Life for Patients With Colorectal or Liver Cancer

By Megan Brooks

February 04, 2020

NEW YORK (Reuters Health) - Newer targeted drug combinations are helping some patients with colorectal or liver cancer live longer and with better quality of life than older drug treatments, according to new data from two large clinical trials.

"Patient-reported outcomes, or PROs, are now recognized as important endpoints of cancer clinical trials that provide important insights regarding the impact of treatment on patients' quality of life," Dr. Richard Schilsky, chief medical officer and executive vice president of the American Society of Clinical Oncology (ASCO), said in a news release. "PROs inform us about the tolerability of new therapies, which is just as important as efficacy in gauging their utility and acceptance by patients."

The BEACON trial (http://bit.ly/2uJVUFq) of patients with metastatic colorectal cancer (CRC) with a BRAF V600E mutation, showed that a combination of encorafenib, binimetinib and cetuximab (triple therapy) and encorafenib plus cetuximab (double therapy) led to better overall survival than standard-of-care chemotherapy (irinotecan plus cetuximab or FOLFIRI plus cetuximab).

Last week, at the 2020 Gastrointestinal Cancers Symposium in San Francisco, Dr. Scott Kopetz of MD Anderson Cancer Center in Houston, Texas, presented patient-reported quality-of-life data from the BEACON trial, which was a secondary endpoint of the study.

Patients treated with the targeted triple therapy had about a 44% to 45% reduction in risk of quality-of-life deterioration compared with patients treated with standard chemotherapy. Those receiving the doublet had a roughly 46% reduction in risk.

"Quality of life (QOL) is an important component of understanding the impact of a treatment on patients," Dr. Kopetz told Reuters Health by email. "These QOL results, in conjunction with the promising efficacy data demonstrating the benefit of the doublet and triplet regimens, confirm the benefit of this treatment for patients with BRAF V600E mutated metastatic colorectal cancer."

The symposium also featured QOL data from the phase-3 IMbrave150 trial of patients with unresectable hepatocellular carcinoma (HCC) who received first-line atezolizumab plus bevacizumab or sorafenib alone (standard of care).

Efficacy data from the trial (https://bit.ly/2OeHBiW) showed that median overall survival had not yet been reached for atezolizumab plus bevacizumab compared with overall survival of 13.2 months for sorafenib alone. The overall response rate was 27% with atezolizumab plus bevacizumab and 12% for sorafenib.

Dr. Peter Galle of the University Medical Center in Mainz, Germany, reported that median time to deterioration of QOL was 11.2 months with the atezolizumab-bevacizumab combination compared with 3.6 months with sorafenib.

Time to decline in physical functioning was also delayed with the combination treatment (median delay, 13.1 vs. 4.9 months with sorafenib). The median time to deterioration of several disease-related symptoms - appetite loss, diarrhea, fatigue, and pain - also took significantly longer following treatment with atezolizumab and bevacizumab versus sorafenib.

"Because it reflects both the effects of disease and the side effects of treatment, sustained or improved quality of life is particularly important for patients," Dr. Galle commented in an ASCO news release. "Patients with liver cancer are typically more fragile and frail than others. Toxicity of the treatments can be much more serious for these patients, and their quality of life can decline quite quickly."

SOURCE: http://bit.ly/2Od7AXW and http://bit.ly/2U7xGzk 2020 Gastrointestinal Cancer Symposium.

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