Quality-adjusted survival in a crossover trial of letrozole versus tamoxifen in postmenopausal women with advanced breast cancer

被引:18
作者
Irish, W
Sherrill, B
Cole, B
Gard, C
Glendenning, GA
Mouridsen, H
机构
[1] Res Triangle Inst, Res Triangle Pk, NC 27709 USA
[2] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA
[3] Novartis Pharmaceut Corp, E Hanover, NJ USA
[4] Rigshosp, DK-2100 Copenhagen, Denmark
关键词
letrozole; Q-TWiST; quality-adjusted survival; tamoxifen;
D O I
10.1093/annonc/mdi275
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Results from a phase III study of postmenopausal women with advanced breast cancer demonstrated longer time to disease progression for patients taking letrozole versus tamoxifen. This analysis compares the trade-offs between progression-free survival and toxicity. Design: Quality-adjusted survival was calculated using Q-TWiST (quality-adjusted time without symptoms or toxicity). Survival curves were partitioned into three health states: toxicity (TOX), disease progression (PROG) and periods without toxicity or disease progression (TWiST). The utility-weighted sum of the health state durations was derived and compared. Results: There was not a significant difference in mean duration of serious adverse events prior to progression between the letrozole (n=453) and tamoxifen (n=454) groups (2.2 and 2 months, respectively). For TWiST, the mean duration for letrozole was 11.5 months, versus 8.5 months for tamoxifen (P < 0.001). The mean duration of PROG was 11.5 months for letrozole and 12.7 months for tamoxifen (P=0.047). Using utility weights of 0.5 for TOX and PROG resulted in a 2.5-month difference in quality-adjusted survival favoring letrozole (P < 0.0001). Conclusions: The longer time to disease progression with letrozole versus tamoxifen was achieved without increased time with adverse events and resulted in more quality-adjusted survival for patients on letrozole.
引用
收藏
页码:1458 / 1462
页数:5
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