Abstract
Purpose
This study aimed to elicit EuroQol Quality of Life 5-Dimensions (EQ-5D) utility values from patients with second-line metastatic colorectal cancer (mCRC) pre- and post-progression.
Methods
A cross-sectional study was conducted in five hospitals in the Netherlands and the UK. Patients with mCRC were eligible if prescribed a second or subsequent line of therapy or best supportive care (BSC), received prior oxaliplatin in first-line therapy, and had Eastern Cooperative Oncology Group (ECOG) performance status scores of 0–2 at second-line initiation. Patients completed the EuroQol Quality of Life 5-Dimensions 3-levels (EQ-5D-3L) questionnaire and were categorized as pre- or post-progression. Chart data including patient demographics, clinical history, prior/current treatments and serious adverse events (SAEs) were collected. Mean utilities were estimated; uni- and multivariate analyses were conducted.
Results
Seventy-five patients were enrolled; 42 were pre-progression defined as second line or third line following an AE on second line and 33 were post-progression defined as third or subsequent therapy lines or BSC. Patient/disease characteristics and number of SAEs were similar between cohorts. Mean utility scores were 0.741 (SD = 0.230) and 0.731 (SD = 0.292) for pre- and post-progression cohorts, respectively. Compared to pre-progression, more patients reported increased anxiety/depression (36 vs. 12 %) and fewer problems with daily activities (64 vs. 38 %) post-progression. More patients pre-progression were on active treatment at enrolment (83 vs. 42 %) compared to post-progression.
Conclusions
This is the first real-world study to collect utilities for patients with second-line mCRC pre- and post-disease progression. Utility values were similar pre- and post-progression. To further explore the effect of radiological progression on utilities, longitudinal research is required that includes patients in palliative care centres.
Similar content being viewed by others
References
Van Cutsem E, Nordlinger E, Cedrvantes A (2010) Advanced colorectal cancer: ESMO Clinical Practice Guidelines for treatment. Ann Oncol 21(suppl 5):v93–v97
Gallagher DJ, Kemeny N (2010) Metastatic colorectal cancer: from improved survival to potential cure. Oncology 78(3–4):237–248
Adam R, Haller DG, Poston G et al (2010) Toward optimized front-line therapeutic strategies in patients with metastatic colorectal cancer—an expert review from the International Congress on Anti-Cancer Treatment (ICACT) 2009. Ann Oncol 21:1579–1584
Grothey A, Sugrue MM, Purdie DM et al (2008) Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol 26(33):5326–5334
National Institute for Health and Clinical Excellence (NICE) (2013) Guide to the methods of technology appraisal. Available at http://publications.nice.org.uk/pmg9
The EuroQol Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208
Kind P (1996) The EuroQol instrument: an index of health-related quality of life. In: Spilker B (ed) Quality of life and pharmacoeconomics in clinical trials, 2nd edn. Lippincott-Raven Publishers, Philadelphia, pp 191–201
Tappenden P, Jones R, Paisley S, Carroll C (2007) Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer. Health Technol Assess 11(12):1–128
Hind D, Tappenden P, Tumur I et al (2008) The use of irinotecan, oxaliplatin and raltitrexed for the treatment of advanced colorectal cancer: systematic review and economic evaluation. Health Technol Assess 12(15):1–182
Bennett L, Zhao Z, Barber B et al (2011) Health-related quality of life in patients with metastatic colorectal cancer treated with panitumumab in first- or second-line treatment. Br J Cancer 105(10):1495–1502
Odom D, Barber B, Bennett L et al (2011) Health-related quality of life and colorectal cancer-specific symptoms in patients with chemotherapy-refractory metastatic disease treated with panitumumab. Int J Color Dis 26(2):173–181
Starling N, Tilden D, White J, Cunningham D (2007) Cost-effectiveness analysis of cetuximab/irinotecan vs active/best supportive care for the treatment of metastatic colorectal cancer patients who have failed previous chemotherapy treatment. Br J Cancer 96(2):206–212
Corrie P, The MABEL study (2005) In Roche Submission to the National Institute for Health and Clinical Excellence (NICE): Bevacizumab in combination with fluoropyrimidine-based chemotherapy for the first-line treatment of metastatic colorectal cancer. An open, uncontrolled, multicentre, phase II study of Erbitux (cetuximab) in combination with irinotecan in patients with metastatic colorectal carcinoma expressing the epidermal growth factor receptor and having progressed on a defined irinotecan-based regimen as most recent treatment 2005. Available at http://www.nice.org.uk/nicemedia/live/12098/46368/46368.pdf. Submitted on July 23, 2009
Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655
Cancer therapy evaluation program, common terminology criteria for adverse events, version 3.0, DCTD, NCI, NIH, DHHS. March 31, 2003 (http://ctep.cancer.gov), Publish date: August 9, 2006
MVH Group (1995) The measurement and valuation of health. Final report on the modeling of valuation tariffs. York Centre for Health Economics
Best JH, Garrison LP, Hollingworth W, Ramsey SD et al (2010) Preference values associated with stage III colon cancer and adjuvant chemotherapy. Qual Life Res 19(3):391–400
Shiroiwa T, Fukuda T, Tsutani K (2009) Cost-effectiveness analysis of XELOX for metastatic colorectal cancer based on the NO16966 and NO16967 trials. Br J Cancer 101(1):12–18
Muszbek N, Benedict A, Hortobagyi L (2013) Quality of the end of life—utility values in advanced solid tumors in technology appraisals in the UK. European CanCer Organisation (ECCO) Congress 2013. 27 September–1 October 2013; Amsterdam, Netherlands
Batty AJ, Pennington B, Lebmeier M et al (2012) A comparison of patient and general-population utility values for advanced melanoma in health economic modeling. ISPOR 15th Annual European Congress. 3–10 November, 2012. Berlin, Germany
Acknowledgments
This study was supported by Sanofi. The authors would like to thank the investigators, their site staff and patients who participated in this study, and Irina Proskorovsky (Evidera) and Karen Yeomans (UBC) for their contributions.
Conflict of interest
Florence Joulain is an employee of Sanofi. Sarah Naoshy and Sheikh Usman Iqbal were employees of Sanofi at the time of study conduct.
S.H. Goey is an employee (Medical Oncologist) of Tweesteden ziekenhuis. He received honoraria from Sanofi to advise on the research described in this article.
David Ferry was an employee of The Dudley Group NHS Foundation Trust. He received honoraria from Sanofi to advise on the research described in this article.
Dara Stein and Krista Payne are employed by United BioSource Corporation (UBC), which provides consulting and other research services to pharmaceutical, device, government and non-governmentorganizations, and received funding from Sanofi to conduct the research described in this article. In this salaried position, Dara Stein and Krista Payne work with a variety of companies and organizations. They receive no payment or honoraria directly from these organizations for services rendered.
Noemi Muszbek is employed by Evidera, which provides consulting and other research services to pharmaceutical, device, government and non-governmentorganizations, and received funding from Sanofi to conduct the research described in this article. In this salaried position, Noemi Muszbek works with a variety of companies and organizations. She receives no payment or honoraria directly from these organizations for services rendered.
Ethical standards
This study was approved by the appropriate ethics committees and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior to their inclusion in the study.
Author information
Authors and Affiliations
Corresponding author
Additional information
S. Naoshy and U. Iqbal were Sanofi employees at the time of study.
D. Ferry was an employee of The Dudley Group NHS Foundation Trust at the time of this study.
Rights and permissions
About this article
Cite this article
Stein, D., Joulain, F., Naoshy, S. et al. Assessing health-state utility values in patients with metastatic colorectal cancer: a utility study in the United Kingdom and the Netherlands. Int J Colorectal Dis 29, 1203–1210 (2014). https://doi.org/10.1007/s00384-014-1980-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-014-1980-1