National and Kapodistrian University of Athens, Laikon Hospital, Athens, Greece.
University Hospital Zürich Skin Cancer Center, Zürich, Switzerland.
Eur J Cancer. 2021 Jul;152:116-128. doi: 10.1016/j.ejca.2021.04.028. Epub 2021 Jun 4.
In COLUMBUS, treatment with encorafenib plus binimetinib in patients with advanced BRAF-mutant melanoma showed improved progression-free and overall survival with favourable tolerability compared to vemurafenib treatment. Here, results on health-related quality of life (HRQoL) are presented.
COLUMBUS was a two-part, open-label, randomised, phase III study in patients with BRAF-mutant melanoma. In PART-I, 577 patients were randomised (1:1:1) to encorafenib plus binimetinib, encorafenib or vemurafenib. The primary objective was to assess progression-free survival. As a secondary objective, HRQoL was assessed by the EQ-5D, the EORTC QLQ-C30 and the FACT-M questionnaires. Furthermore, time to definitive 10% deterioration was estimated with a Kaplan-Meier analysis and differences in mean scores between groups were calculated with a mixed-effect model for repeated measures. Hospitalisation rate and the impact of hospitalisation on HRQoL were also assessed.
Patients receiving the combination treatment showed improvement of their FACT-M and EORTC QLQ-C30 global health status scores, compared to those receiving vemurafenib (post-baseline score differences: 3.03 [p < 0.0001] for FACT M and 5.28 [p = 0.0042] for EORTC QLQ-C30), indicative of a meaningful change in patient's status. Furthermore, a delay in the deterioration of QoL was observed in non-hospitalised patients compared to hospitalised patients (hazard ratio [95% CI]: 1.16 [0.80; 1.68] for EORTC QLQ-C30 and 1.27 [0.81; 1.99] for FACT-M) and a risk reduction of 10% deterioration, favoured the combination in both groups.
The improved efficacy of encorafenib plus binimetinib compared to vemurafenib, translates into a positive impact on the perceived health status as assessed by the HRQoL questionnaires. The study is registered with ClinicalTrials.gov, number NCT01909453 and EudraCT number 2013-001176-38.
在 COLUMBUS 研究中,与维莫非尼治疗相比,接受恩考芬尼联合比美替尼治疗的晚期 BRAF 突变型黑色素瘤患者的无进展生存期和总生存期得到改善,且耐受性良好。此处报告了健康相关生活质量(HRQoL)的结果。
COLUMBUS 是一项两部分、开放性、随机、III 期研究,入组了 BRAF 突变型黑色素瘤患者。在 PART-I 中,577 例患者按 1:1:1 比例随机分配至恩考芬尼联合比美替尼、恩考芬尼或维莫非尼组。主要终点是评估无进展生存期。次要终点是通过 EQ-5D、EORTC QLQ-C30 和 FACT-M 问卷评估 HRQoL。此外,通过 Kaplan-Meier 分析估计明确恶化的 10%时间,并通过混合效应模型重复测量计算组间平均评分的差异。还评估了住院率以及住院对 HRQoL 的影响。
与接受维莫非尼治疗的患者相比,接受联合治疗的患者的 FACT-M 和 EORTC QLQ-C30 整体健康状况评分得到改善(治疗后基线评分差异:FACT-M 为 3.03 [p<0.0001],EORTC QLQ-C30 为 5.28 [p=0.0042]),表明患者状况发生了有意义的变化。此外,与住院患者相比,非住院患者的 QoL 恶化延迟(EORTC QLQ-C30 的风险比[95%CI]为 1.16[0.80; 1.68],FACT-M 为 1.27[0.81; 1.99]),联合治疗在两个组中都降低了 10%恶化的风险。
与维莫非尼相比,恩考芬尼联合比美替尼的疗效改善转化为 HRQoL 问卷评估的健康感知状态的积极影响。该研究在 ClinicalTrials.gov 注册,编号为 NCT01909453,EudraCT 编号为 2013-001176-38。