Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status

Maria Thomsen; Marianne Grønlie Guren; Eva Skovlund; Bengt Glimelius; Marianne Jensen Hjermstad; Julia S. Johansen; Elin Kure; Halfdan Sorbye; Per Pfeiffer; Thoralf Christoffersen; Tormod Kyrre Guren; Kjell Magne Tveit

doi:10.1016/j.ejca.2017.04.026

Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status

Maria Thomsen^*, Marianne Grønlie Guren, Eva Skovlund, Bengt Glimelius, Marianne Jensen Hjermstad, Julia S. Johansen, Elin Kure, Halfdan Sorbye, Per Pfeiffer, Thoralf Christoffersen, Tormod Kyrre Guren, Kjell Magne Tveit

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

7 Citationer (Scopus)

Abstract

Background The aim of this study was to evaluate the effect of cetuximab on health-related quality of life (HRQoL) in the NORDIC-VII trial on metastatic colorectal cancer (mCRC), and to assess HRQoL in relation to RAS and BRAF mutation status and inflammatory biomarkers. Patient and methods HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline, after every fourth cycle of chemotherapy, and at the end of treatment. HRQoL during 12 cycles of chemotherapy was evaluated over time, compared between treatment arms, and assessed for association with tumour mutation status and inflammatory markers. Results QLQ-C30 was completed by 512 patients (90%) before start of treatment. HRQoL variables were well balanced across treatment arms at baseline, and no statistically significant differences during treatment were seen. Patients with BRAF-mutated tumours reported poorer HRQoL at baseline and subsequent time points than patients with RAS-mutated or RAS/BRAF wild-type tumours. Patients with high serum interleukin-6 (IL-6) or C-reactive protein (CRP) had markedly impaired HRQoL compared to patients with normal levels. There was a statistically significant association between reduction in IL-6 and CRP levels and improvement in HRQoL during treatment from baseline to cycle 4. Conclusion The addition of cetuximab to chemotherapy did not affect HRQoL in mCRC patients. Patients with BRAF-mutated tumours have both a worse prognosis and a poor HRQoL. The associations between levels of systemic inflammatory markers and reduced HRQoL suggest that the patients might benefit from anti-inflammatory treatment.

Originalsprog	Engelsk
Tidsskrift	European Journal of Cancer
Vol/bind	81
Sider (fra-til)	26-35
ISSN	0959-8049
DOI	https://doi.org/10.1016/j.ejca.2017.04.026
Status	Udgivet - 2017

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10.1016/j.ejca.2017.04.026

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Thomsen, M., Guren, M. G., Skovlund, E., Glimelius, B., Hjermstad, M. J., Johansen, J. S., Kure, E., Sorbye, H., Pfeiffer, P., Christoffersen, T., Guren, T. K., & Tveit, K. M. (2017). Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status. European Journal of Cancer, 81, 26-35. https://doi.org/10.1016/j.ejca.2017.04.026

Thomsen, M, Guren, MG, Skovlund, E, Glimelius, B, Hjermstad, MJ, Johansen, JS, Kure, E, Sorbye, H, Pfeiffer, P, Christoffersen, T, Guren, TK & Tveit, KM 2017, 'Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status', European Journal of Cancer, bind 81, s. 26-35. https://doi.org/10.1016/j.ejca.2017.04.026

@article{7c4d721ca674428fa4660a6225ad552e,

title = "Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status",

abstract = "Background The aim of this study was to evaluate the effect of cetuximab on health-related quality of life (HRQoL) in the NORDIC-VII trial on metastatic colorectal cancer (mCRC), and to assess HRQoL in relation to RAS and BRAF mutation status and inflammatory biomarkers. Patient and methods HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline, after every fourth cycle of chemotherapy, and at the end of treatment. HRQoL during 12 cycles of chemotherapy was evaluated over time, compared between treatment arms, and assessed for association with tumour mutation status and inflammatory markers. Results QLQ-C30 was completed by 512 patients (90%) before start of treatment. HRQoL variables were well balanced across treatment arms at baseline, and no statistically significant differences during treatment were seen. Patients with BRAF-mutated tumours reported poorer HRQoL at baseline and subsequent time points than patients with RAS-mutated or RAS/BRAF wild-type tumours. Patients with high serum interleukin-6 (IL-6) or C-reactive protein (CRP) had markedly impaired HRQoL compared to patients with normal levels. There was a statistically significant association between reduction in IL-6 and CRP levels and improvement in HRQoL during treatment from baseline to cycle 4. Conclusion The addition of cetuximab to chemotherapy did not affect HRQoL in mCRC patients. Patients with BRAF-mutated tumours have both a worse prognosis and a poor HRQoL. The associations between levels of systemic inflammatory markers and reduced HRQoL suggest that the patients might benefit from anti-inflammatory treatment.",

keywords = "Chemotherapy, HRQoL, Inflammation, mCRC, RAS and BRAF mutation status",

author = "Maria Thomsen and Guren, {Marianne Gr{\o}nlie} and Eva Skovlund and Bengt Glimelius and Hjermstad, {Marianne Jensen} and Johansen, {Julia S.} and Elin Kure and Halfdan Sorbye and Per Pfeiffer and Thoralf Christoffersen and Guren, {Tormod Kyrre} and Tveit, {Kjell Magne}",

year = "2017",

doi = "10.1016/j.ejca.2017.04.026",

language = "English",

volume = "81",

pages = "26--35",

journal = "European Journal of Cancer, Supplement",

issn = "0959-8049",

publisher = "Pergamon",

}

TY - JOUR

T1 - Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status

AU - Thomsen, Maria

AU - Guren, Marianne Grønlie

AU - Skovlund, Eva

AU - Glimelius, Bengt

AU - Hjermstad, Marianne Jensen

AU - Johansen, Julia S.

AU - Kure, Elin

AU - Sorbye, Halfdan

AU - Pfeiffer, Per

AU - Christoffersen, Thoralf

AU - Guren, Tormod Kyrre

AU - Tveit, Kjell Magne

PY - 2017

Y1 - 2017

N2 - Background The aim of this study was to evaluate the effect of cetuximab on health-related quality of life (HRQoL) in the NORDIC-VII trial on metastatic colorectal cancer (mCRC), and to assess HRQoL in relation to RAS and BRAF mutation status and inflammatory biomarkers. Patient and methods HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline, after every fourth cycle of chemotherapy, and at the end of treatment. HRQoL during 12 cycles of chemotherapy was evaluated over time, compared between treatment arms, and assessed for association with tumour mutation status and inflammatory markers. Results QLQ-C30 was completed by 512 patients (90%) before start of treatment. HRQoL variables were well balanced across treatment arms at baseline, and no statistically significant differences during treatment were seen. Patients with BRAF-mutated tumours reported poorer HRQoL at baseline and subsequent time points than patients with RAS-mutated or RAS/BRAF wild-type tumours. Patients with high serum interleukin-6 (IL-6) or C-reactive protein (CRP) had markedly impaired HRQoL compared to patients with normal levels. There was a statistically significant association between reduction in IL-6 and CRP levels and improvement in HRQoL during treatment from baseline to cycle 4. Conclusion The addition of cetuximab to chemotherapy did not affect HRQoL in mCRC patients. Patients with BRAF-mutated tumours have both a worse prognosis and a poor HRQoL. The associations between levels of systemic inflammatory markers and reduced HRQoL suggest that the patients might benefit from anti-inflammatory treatment.

AB - Background The aim of this study was to evaluate the effect of cetuximab on health-related quality of life (HRQoL) in the NORDIC-VII trial on metastatic colorectal cancer (mCRC), and to assess HRQoL in relation to RAS and BRAF mutation status and inflammatory biomarkers. Patient and methods HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline, after every fourth cycle of chemotherapy, and at the end of treatment. HRQoL during 12 cycles of chemotherapy was evaluated over time, compared between treatment arms, and assessed for association with tumour mutation status and inflammatory markers. Results QLQ-C30 was completed by 512 patients (90%) before start of treatment. HRQoL variables were well balanced across treatment arms at baseline, and no statistically significant differences during treatment were seen. Patients with BRAF-mutated tumours reported poorer HRQoL at baseline and subsequent time points than patients with RAS-mutated or RAS/BRAF wild-type tumours. Patients with high serum interleukin-6 (IL-6) or C-reactive protein (CRP) had markedly impaired HRQoL compared to patients with normal levels. There was a statistically significant association between reduction in IL-6 and CRP levels and improvement in HRQoL during treatment from baseline to cycle 4. Conclusion The addition of cetuximab to chemotherapy did not affect HRQoL in mCRC patients. Patients with BRAF-mutated tumours have both a worse prognosis and a poor HRQoL. The associations between levels of systemic inflammatory markers and reduced HRQoL suggest that the patients might benefit from anti-inflammatory treatment.

KW - Chemotherapy

KW - HRQoL

KW - Inflammation

KW - mCRC

KW - RAS and BRAF mutation status

U2 - 10.1016/j.ejca.2017.04.026

DO - 10.1016/j.ejca.2017.04.026

M3 - Journal article

C2 - 28595137

AN - SCOPUS:85020168532

SN - 0959-8049

VL - 81

SP - 26

EP - 35

JO - European Journal of Cancer, Supplement

JF - European Journal of Cancer, Supplement

ER -

Health-related quality of life in patients with metastatic colorectal cancer, association with systemic inflammatory response and RAS and BRAF mutation status

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