Patient-Reported Outcome Results from the Open-Label Randomized Phase III SELECT BC Trial Evaluating First-Line S-1 Therapy for Metastatic Breast Cancer

Oncology. 2018;94(2):107-115. doi: 10.1159/000484142. Epub 2017 Nov 17.

Abstract

Objective: To evaluate the effects of S-1, an orally administered 5-FU agent, versus taxane on patient-reported outcomes (PROs) in the SELECT BC trial.

Methods: Patients with HER2-negative and endocrine treatment-resistant breast cancer with metastasis or recurrence after surgery were randomly assigned to receive first-line taxane or S-1. PROs (secondary endpoint) were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Patient Neurotoxicity Questionnaire (PNQ) at baseline and at 3, 6, and 12 months. We conducted a responder analysis for the QLQ-C30 and PNQ and created cumulative distribution function (CDF) plots as a sensitivity analysis.

Results: The questionnaire response rates were over 80% from 386 patients, who completed at least one baseline questionnaire. S-1 was significantly superior to taxane with respect to 6 scales (physical functioning [p = 0.03], role functioning [p = 0.04], social functioning [p < 0.01], financial difficulties [p = 0.01], global health status [p = 0.02], and constipation [p < 0.01]) and sensory neuropathy (p = 0.01). The CDF plots partially supported the conclusions and their robustness.

Conclusion: First-line S-1 therapy has clinical benefits with respect to many aspects of health-related quality of life for metastatic breast cancer patients.

Keywords: Adjuvant chemotherapy; Chemotherapy-induced peripheral neuropathy; Clinical trials; Health-related quality of life; Metastatic breast cancer.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Bridged-Ring Compounds / therapeutic use
  • Drug Combinations
  • Female
  • Fluorouracil / therapeutic use
  • Health Status
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Oxonic Acid / therapeutic use*
  • Patient Reported Outcome Measures
  • Quality of Life
  • Surveys and Questionnaires
  • Taxoids / therapeutic use
  • Tegafur / therapeutic use*

Substances

  • Antineoplastic Agents
  • Bridged-Ring Compounds
  • Drug Combinations
  • Taxoids
  • S 1 (combination)
  • Tegafur
  • taxane
  • Oxonic Acid
  • Fluorouracil