Health-related quality of life in patients with fully resected BRAFV600 mutation-positive melanoma receiving adjuvant vemurafenib

Eur J Cancer. 2019 Dec:123:155-161. doi: 10.1016/j.ejca.2019.09.019. Epub 2019 Nov 5.

Abstract

Aim of study: The aim of the study was to assess the impact of treatment with adjuvant vemurafenib monotherapy on health-related quality of life (HRQOL) in patients with resected stage IIC-IIIC melanoma.

Methods: The phase 3 BRIM8 study (NCT01667419) randomised patients with BRAFV600 mutation-positive resected stage IIC-IIIC melanoma to 960 mg of vemurafenib twice daily or matching placebo for 52 weeks (13 × 28-day cycles). Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) version 3 at baseline, cycle 1 (days 1, 15 and 22), cycle 2 (days 1 and 15), day 1 of every subsequent 4-week cycle, the end-of-treatment visit and each visit during the follow-up period.

Results: Completion rates for the EORTC QLQ-C30 questionnaire were high (>80%). There was a mean decline in the global health status (GHS)/quality of life (QOL) score of 17.4 (±22.9) and 17.3 (±24.1) points at days 15 and 22 of cycle 1, respectively, among vemurafenib-treated patients who recovered to approximately 10 points below baseline for the remainder of the treatment period. A similar trend was observed in all functional scales except for cognitive function (<10-point change from baseline at all visits) and in the symptom scores for appetite loss, fatigue and pain. As observed for the GHS/QOL score, all scores rapidly returned to baseline after completion of planned vemurafenib treatment or treatment discontinuation.

Conclusions: The schedule of HRQOL assessments allowed for an accurate and complete evaluation of the impact of acute treatment-related symptoms. Vemurafenib-treated patients experience clinically meaningful moderate worsening in some treatment- or disease-related symptoms and GHS/QOL that resolve over time.

Keywords: Adjuvant treatment; BRAF; Health-related quality of life; Resected melanoma; Vemurafenib.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anorexia / physiopathology
  • Anorexia / psychology
  • Antineoplastic Agents / therapeutic use*
  • Chemotherapy, Adjuvant*
  • Cognitive Dysfunction / physiopathology
  • Cognitive Dysfunction / psychology
  • Dermatologic Surgical Procedures*
  • Fatigue / physiopathology
  • Fatigue / psychology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Melanoma / drug therapy*
  • Melanoma / genetics
  • Melanoma / physiopathology
  • Melanoma / psychology
  • Middle Aged
  • Pain / physiopathology
  • Pain / psychology
  • Proto-Oncogene Proteins B-raf / genetics
  • Quality of Life*
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / genetics
  • Skin Neoplasms / physiopathology
  • Skin Neoplasms / psychology
  • Vemurafenib / therapeutic use*
  • Young Adult

Substances

  • Antineoplastic Agents
  • Vemurafenib
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf