Lebioda A, Krieger T, Kuhn A. Metastatic colorectal cancer (MCRC) – literature review on quality of life instruments. Poster presented at the ISPOR 21st Annual European Congress; November 14, 2018. Barcelona, Spain.


OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer in Europe, and 30% of patients with CRC present with metastatic disease (mCRC). While clinical measures, such as survival, response and safety, reveal the patients´ health and disease status, it may not necessarily capture the full treatment impact on how a patient feels. Health-related quality of life (HRQoL) provide patients´ perspectives. Therefore, a literature review was conducted, to assess HRQoL in mCRC patients, instruments used and potential differences.

METHODS: A literature search was performed using the Embase and MEDLINE databases. The search was limited to studies published from 2006 to present. Search results on abstract and full-text level were screened based on predefined in- and exclusion criteria (population, intervention, study type, and outcomes).

RESULTS: In total 598 records were identified. After duplicates, abstract and full text screening, 36 studies were included in the review. Instruments published, were primarily the EORTC QLQ-C30 (n=19), EQ-5D (n=7), FACT-C (n=6) and SF-36 (n=4). The EORTC QLQ-C30 showed significant differences between treatments compared to best supportive care (BSC) in only one of the 19 studies. No differences were observed with the FACT-C (n=6). Data of the EQ-5D showed a numerical trend and improvements for a better HRQoL compared to BSC. Differences for the physical function component of the SF-36 were seen in three studies.

CONCLUSIONS: The EORTC QLQ-C30 and EQ-5D were the most common HRQoL instruments used in mCRC trials. No instrument was identified, that shows more differences than another does, probably because studies were not powered for the HRQoL, as it never was specified as a primary or secondary endpoint. Often, more than one instrument was used, i.e. a mCRC-specific with a generic instrument depending on study purpose. As numerous factors affect the ability of a study to demonstrate HRQoL benefit across treatments, further investigation is needed.

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