Important Group Differences on the Functional Assessment of Cancer Therapy-Kidney Symptom Index Disease-Related Symptoms in Patients with Metastatic Renal Cell Carcinoma

Value Health. 2018 Dec;21(12):1413-1418. doi: 10.1016/j.jval.2018.04.1371. Epub 2018 May 11.

Abstract

Background: The Functional Assessment of Cancer Therapy-Kidney Symptom Index Disease-Related Symptoms (FKSI-DRS) is important to gauge clinical benefit in metastatic renal cell carcinoma (mRCC).

Objectives: To estimate important difference (ID) in FKSI-DRS scores that is considered to be meaningful when comparing treatment effect between groups, using mRCC trial data.

Methods: Data were derived from two pivotal phase III mRCC trials comparing sunitinib versus interferon alfa (N = 750) in first-line mRCC, and axitinib versus sorafenib (N = 723) in second-line mRCC. The change from baseline in FKSI-DRS score was examined as a function of a set of anchors using the repeated-measures model. Several anchors were evaluated: FKSI item "I am bothered by side effects of treatment," EuroQol five-dimensional questionnaire utility score, and adverse events.

Results: When the "I am bothered by side effects of treatment" score was used as an anchor, the ID ranged between 1.2 and 1.3 points. When change in the EuroQol five-dimensional questionnaire utility score was used as an anchor, the FKSI-DRS ID ranged between 0.62 and 0.63 points. Selecting the adverse events that corresponded to a maximum worsening in the FKSI-DRS score in either trial, the ID ranged between 0.62 and 0.74 points.

Conclusions: Among patients undergoing treatment for mRCC, between-group differences in FKSI-DRS scores as low as 1 point might be meaningful.

Keywords: clinically important difference; health-related quality of life; renal cell carcinoma; targeted therapy.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Axitinib / adverse effects
  • Axitinib / therapeutic use
  • Carcinoma, Renal Cell / complications*
  • Carcinoma, Renal Cell / drug therapy
  • Female
  • Humans
  • Interferon-alpha / adverse effects
  • Interferon-alpha / therapeutic use
  • Kidney Neoplasms / complications*
  • Kidney Neoplasms / drug therapy
  • Male
  • Middle Aged
  • Quality of Life*
  • Sorafenib / adverse effects
  • Sorafenib / therapeutic use
  • Sunitinib / adverse effects
  • Sunitinib / therapeutic use
  • Surveys and Questionnaires

Substances

  • Antineoplastic Agents
  • Interferon-alpha
  • Sorafenib
  • Axitinib
  • Sunitinib