1. Relationship between molecular response and quality of life with bosutinib or imatinib for chronic myeloid leukemia.
- Author
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Brümmendorf, Tim H., Gambacorti-Passerini, Carlo, Bushmakin, Andrew G., Cappelleri, Joseph C., Viqueira, Andrea, Reisman, Arlene, Isfort, Susanne, and Mamolo, Carla
- Subjects
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CHRONIC myeloid leukemia , *QUALITY of life , *IMATINIB , *PROTEIN-tyrosine kinases , *PATIENT selection , *MENTAL health , *THERAPEUTIC use of antineoplastic agents , *QUINOLINE , *RESEARCH , *CLINICAL trials , *RESEARCH methodology , *ORGANIC compounds , *EVALUATION research , *MEDICAL cooperation , *AMINES , *TREATMENT effectiveness , *COMPARATIVE studies , *RANDOMIZED controlled trials - Abstract
Patients with newly diagnosed chronic phase chronic myeloid leukemia (CP CML) can be effectively treated with tyrosine kinase inhibitors (TKIs) and achieve a lifespan similar to the general population. The success of TKIs, however, requires long-term and sometimes lifelong treatment; thus, patient-assessed health-related quality of life (HRQoL) has become an increasingly important parameter for treatment selection. Bosutinib is a TKI approved for CP CML in newly diagnosed adults and in those resistant or intolerant to prior therapy. In the Bosutinib Trial in First-Line Chronic Myelogenous Leukemia Treatment (BFORE), bosutinib demonstrated a significantly higher major molecular response rate compared with imatinib, with maintenance of HRQoL (measured by the Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) questionnaire), after 12 months of first-line treatment. We examined relationships between molecular response (MR) and HRQoL. MR values were represented by a log-reduction scale (MRLR; a continuous variable). A repeated-measures longitudinal model was used to estimate the relationships between MRLR as a predictor and each FACT-Leu domain as an outcome. Effect sizes were calculated to determine strength of effects and allow comparisons across domains. The majority of FACT-Leu domains (with the exception of social well-being and physical well-being) demonstrated a significant relationship with MRLR (p < 0.05). Our results showed variable impact of clinical improvement on different dimensions of HRQoL. For patients who achieved MR5, emotional well-being and leukemia-specific domains showed the greatest improvement, with medium differences in effect sizes, whereas social well-being and physical well-being had the weakest relationship with MR. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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