(UroToday.com) The 2022 International Kidney Cancer Symposium (IKCS) European Annual meeting included an oral abstract session and presentation by Dr. Cristiane Bergerot discussing the results of a patient survey assessing the relevance of items in the FACT Kidney Cancer Symptom Inventory-19 (FKSI-19). Health-related quality of life has been evaluated in randomized phase III trials, including in metastatic renal cell carcinoma (RCC), and the correlation between treatment toxicities and health-related quality of life is of pivotal importance for clinical decision making. However, there is a lack of consensus regarding which health-related quality of life assessment tool should be utilized and preferred. There are several current challenges, including (i) the questionnaires being previously tested and validated among patients receiving outdated therapeutic regimens, (ii) the sensitivity of current measures may vary with different disease stages, and (iii) it is likely that there is different quality of life concerns faced by patients with localized disease as opposed to those with metastatic disease. The goals of the current study were to determine the relevance of questions currently incorporated into health-related quality of life metrics for RCC, and specifically to:
- Identify elements that impact health-related quality of life outside of those included in currently utilized health-related quality of life metrics
- Differentiate between treatment and cancer health-related quality of life issues
- Qualitatively assess patient perceptions around existing health-related quality of life tools for RCC
This was a cohort study with eligible patients having metastatic RCC. Patients were presented with the elements of the FKSI-19 to evaluate and they were asked to rate each item in terms of its relevance to their overall health-related quality of life on a 5-point Likert scale, as well as respond to one open-ended question regarding any topics not covered by the FKSI-19. Questions from FKSI-19 were identified as either relevant (score 4-5), possibly valuable (score 3), or non-relevant (score 1-2). Open-ended questions were analyzed by 2 independent reviewers and categorized into descriptive categories.
Among 95 patients, the median age was 64 years (range 37-85), 77.9% were male, 73.7% were married, 26.3% of patients had some college education, and 68.4% were white. With regards to treatment, 31.6% received immunotherapy, 37.9% targeted therapy, and 16.8% combination therapy. The median time on treatment was 12 months (range: 1-120). The results of the questions regarding relevance to patients’ overall health-related quality of life are as follows:
Specifically, items that were relevant to patients included pain (30%), fatigue (29%), and worry (29%). Items that were non-relevant to patients included fever (89%), blood in the urine (87%), coughing (81%), and nausea (81%). The most common symptom that was attributed to cancer was worry and the most common symptom that was attributed to treatment was diarrhea:
Patients also conveyed valuable information about how long surveys should be in that the optimal number of questions was deemed to be 15-30 questions, and the maximum number of questions was deemed to be 30 questions. Additionally, patients also reported how often they should be assessed, with the most common interval being every 3 months (vs every month vs every 2 weeks vs every other day/week). This study also reported several suggestions for additional questions that should be included in a survey from the patient’s perspective, as highlighted in the following table:
Dr. Bergerot noted several limitations of the study, including the small sample size, only one overall health-related quality of life measure was evaluated, and there was no comparison between localized and metastatic disease.
Dr. Bergerot concluded her presentation by discussing the results of a patient survey assessing the relevance of items in the FKSI-19 survey with the following take-home messages:
- Current measures include questions rated as non-relevant by patients with kidney cancer included fever, blood in the urine, coughing, and nausea
- The optimal number of questions may range between 15 to 30
- Health-related quality of life should be measured every 3 months and measures should be refined for patients with metastatic RCC
- These findings will be validated in an upcoming study of patients with RCC receiving treatment in the metastatic and adjuvant settings
Presented by: Cristiane Decat Bergerot, PhD, Department of Psycho-Oncology, CETTRO Cancer Research Hospital, Brasilia, Brazil
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 International Kidney Cancer Symposium (IKCS) Europe Annual Hybrid Meeting, Antwerp, Belgium, Fri, Apr 22 – Sun, Apr 24, 2022.