Quality of life without toxicity or symptoms analysis of a randomized controlled clinical trial comparing efficacy of cabazitaxel versus docetaxel in recurrent head and neck cancer

• Main Authors: Vijay Patil, Amit Joshi, Vanita Noronha, Sachin Dhumal, Arun Chandrasekharan, Nikhil Pande, Sameer Shrirangwar, Anup Toshniwal, Siddharth Turkar, Kushal Gupta, Vikas Talreja, Abhishek Mahajan, Shashikant Juvekar, Atanu Bhattacharjee, Kumar Prabhash
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Cancer Research, Statistics, and Treatment
• Subjects: cabazitaxel; docetaxel; head and neck cancer; quality of life; quality of life without toxicity or symptoms
• Online Access: http://www.crstonline.com/article.asp?issn=2590-3233;year=2018;volume=1;issue=1;spage=46;epage=50;aulast=
• ISSN: 2590-3233; 2590-3225

Background: This analysis was done with the aim to study the overall impact of docetaxel and cabazitaxel treatment using quality-adjusted time without symptoms and toxicity (QTWiST) analysis in head and neck cancer patients receiving second-line treatment. Methods: Overall survival (OS) was partitioned in three health states for QTWiST analysis. Toxicity (TOX) state was defined as the cumulative number of days spent in grade 3 or above toxicity postrandomization and before progression. TWiST state was defined as the cumulative number of days spent postrandomization and before progression without grade 3 or above toxicity. REL state was defined as the time spent in days postprogression till death. A threshold utility analysis was performed. Results: The restricted mean TOX state duration in cabazitaxel arm was 2.26 days (95% confidence interval [CI] 1.12–3.40) versus 1.54 days (95% CI 0.56–2.53 days) in docetaxel arm. In threshold utility analysis, the mean difference in QTWiST was in favor of docetaxel arm and ranged from −7.194 (utility for TOX) to −35.96. For any combination of utility score of REL >0, with any combination of utility score of TOX, the difference in mean QTWiST between the two arms was >14 days (i.e. >10% of OS), in favor of docetaxel arm which is considered clinically meaningful. Conclusion: Patients randomized to docetaxel arm had a higher QTWiST score than patients in cabazitaxel arm. There was a suggestion that docetaxel led to better quallity of life without toxicity or symptoms, which would require confirmation in a larger study.