The effect of chemotherapy on health-related quality of life in mesothelioma: Results from the SWAMP trial

Arnold, D. T.; Hooper, C. E.; Morley, A.; White, P.; Lyburn, I. D.; Searle, J.; Darby, M.; Hall, T.; Hall, D.; Rahman, N. M.; De Winton, E.; Clive, A.; Masani, V.; Dangoor, A.; Guglani, S.; Jankowska, P.; Lowndes, S. A.; Harvey, J. E.; Braybrooke, J. P.; Maskell, Nick A

Abstract

© 2015 Cancer Research UK. All rights reserved. Background: The effect of chemotherapy on health-related quality of life (HRQoL) in malignant pleural mesothelioma (MPM) is poorly understood. Patient-individualised prognostication and prediction of treatment response from chemotherapy is useful but little evidence exists to guide practice. Method: Consecutive patients with MPM who were fit for first-line chemotherapy with pemetrexed and cisplatin\carboplatin were recruited and followed up for a minimum of 12 months. This study focussed on the HRQoL outcomes of these patients using the EQ-5D, EORTC QLQ-C30 and LC13. Results: Seventy-three patients were recruited of which 58 received chemotherapy and 15 opted for best supportive care (BSC). Compliance with HRQoL questionnaires was 98% at baseline. The chemotherapy group maintained HRQoL compared with the BSC group whose overall HRQoL fell (P=0.006) with worsening dyspnoea and pain. The impact of chemotherapy was irrespective of histological subtype although those with non-epithelioid disease had worse HRQoL at later time points (P=0.012). Additionally, those with a falling mesothelin or improvement on modified-RECIST CT at early follow-up had a better HRQoL at 16 weeks. Conclusions: HRQoL was maintained following chemotherapy compared with a self-selected BSC group. Once chemotherapy is initiated, a falling mesothelin or improved RECIST CT findings infer a quality-of-life advantage.

• Journal Article Type: Article
• Acceptance Date: Feb 1, 2015
• Online Publication Date: Mar 10, 2015
• Publication Date: Mar 31, 2015
• Deposit Date: Aug 3, 2015
• Publicly Available Date: Feb 22, 2016
• Journal: British Journal of Cancer
• Print ISSN: 0007-0920
• Electronic ISSN: 1532-1827
• Publisher: Springer Nature [academic journals on nature.com]
• Peer Reviewed: Peer Reviewed
• Volume: 112
• Issue: 7
• Pages: 1183-1189
• DOI: https://doi.org/10.1038/bjc.2015.77
• Keywords: mesothelioma, chemotherapy, quality of life
• Public URL: https://uwe-repository.worktribe.com/output/840692
• Publisher URL: http://dx.doi.org/10.1038/bjc.2015.77
• Contract Date: Feb 22, 2016