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Review
. 2015 May 29;7(2):950-62.
doi: 10.3390/cancers7020817.

Quality of Life in Patients with NSCLC Receiving Maintenance Therapy

Achim Rittmeyer  1
Affiliations
Review

Quality of Life in Patients with NSCLC Receiving Maintenance Therapy

Achim Rittmeyer. Cancers (Basel). .

Abstract

Introduction: In the past few years many trials have evaluated the use of maintenance therapy in the treatment of NSCLC stage IV. Both switch as well as continuation maintenance show an improved PFS and overall survival. HRQoL data was only partially published. The aim of this article is to review the published effects of maintenance therapy on HRQoL.

Methods: Two PubMed searches were performed using the terms: "maintenance therapy and NSCLC" and "maintenance therapy and NSCLC and HRQoL". The published data was compared, analysed and evaluated.

Results: 272 articles were found dealing with maintenance therapy, and of these 85 articles were found regarding maintenance therapy and HRQoL in NSCLC. Maintenance therapy showed no negative impact on HRQoL but failed to show a real benefit. Some symptoms showed positive trends during maintenance therapy. HRQoL can be used to select patients for maintenance therapy.

Conclusions: Maintenance therapy is very safe, improves PFS and OS without impairing HRQoL. Although a positive impact on general QoL could not be demonstrated this is possibly due to the mode of evaluating HRQoL. Patient reported outcomes should be simplified and examined for a longer period of time.

Keywords: HRQoL; NSCLC; maintenance therapy.

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Figures

Figure 1
Figure 1
(A): HRQoL in the ITT population of the Paramount trial during four cycles of induction pemetrexed/cisplatin; (B): HRQoL in the maintenance population of the Paramount trial during six cycles of maintenance therapy. Modified from [29].
Figure 2
Figure 2
(A): Symptom score for fatigue in the maintenance population of the Avaperl trial during four cycles off induction pemetrexed/cisplatin/bevacizumab (0–4) and eleven cycles of maintenance (M1–11)with either bevacizumab alone (blue line) or pemetrexed plus bevacizumab (red line); (B): Symptom score for pain in the maintenance population of the Avaperl trial during four cycles off induction pemetrexed/cisplatin/bevacizumab and eleven cycles of maintenance with bevacizumab alone (blue line) or pemetrexed plus bevacizumab (red line) Modified from [22].
Figure 2
Figure 2
(A): Symptom score for fatigue in the maintenance population of the Avaperl trial during four cycles off induction pemetrexed/cisplatin/bevacizumab (0–4) and eleven cycles of maintenance (M1–11)with either bevacizumab alone (blue line) or pemetrexed plus bevacizumab (red line); (B): Symptom score for pain in the maintenance population of the Avaperl trial during four cycles off induction pemetrexed/cisplatin/bevacizumab and eleven cycles of maintenance with bevacizumab alone (blue line) or pemetrexed plus bevacizumab (red line) Modified from [22].
See this image and copyright information in PMC

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