Preventing the spread of the tumor may not improve the quality of life

A new study suggests that cancer drugs that prevent the growth of tumors do not lead to a better quality of life for patients.

"In countries where patients have to pay a share, they can use all their savings to access these expensive new drugs. In the end, they may not prolong their lives or improve their quality of life, "Feng Xie, a professor of health economics at McMaster University, told Reuters Health.

Xie and his colleagues reanalyzed data from nearly 40 randomized trials of several types of cancer. They found that "progression-free survival," or the length of time physicians could keep cancer under control, was not related to quality of life related to health.

Today, cancer researchers and pharmaceutical companies often use progression-free survival to measure the effectiveness of a new drug, Xie explained over the phone.

"In the past, when a new drug was developed, overall survival," that is, the patient's life span, "was the criterion to be evaluated. Many drugs have now been approved based on the benefit of progression-free survival, "said Xie.

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One of the reasons to use progression-free survival as a marker of effectiveness is that it can be measured earlier than overall survival, so new drugs can be treated more quickly , says Xie and his colleagues in JAMA Internal Medicine.

The problem, according to Xie, is that progression-free survival, measured in the short term, does not necessarily predict a longer life span. And as the new study shows, it could also not predict a better quality of life.

"In cancer patients, evaluating a therapy involves two important things: prolonging survival and improving quality of life (even if it does not increase survival)," explained Xie.

Although many studies have measured progression-free survival, most have not reported quality of life related to health. Xie and his colleagues were able to find 38 studies, including 13,979 cancer patients with 12 different types of cancer, who reviewed both endpoints.

Data collected from the 38 studies showed no significant association between progression-free survival and quality of life.

Researchers had difficulty comparing study data because quality of life was not always measured in the same way. Xie hopes that in the future, researchers will standardize how they measure quality of life.

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Dr. Robert Ferris, director of the Hillman Cancer Center at the University of Pittsburgh Medical Center, is not prepared to consider progression-free survival as an indicator of the effectiveness of an anti-cancer drug. But the early marker may underestimate or overestimate the value of a drug, Ferris said during a phone interview.

"A quick response does not always predict long-term survival," said Ferris, who is not affiliated with the new research. "For example, immunotherapy drugs are known for their long-term benefits, but they can not have a quick removal of the tumor."

In addition, said Ferris, measuring the quality of life can be tricky. "Everyone sees things differently," he explained. "Some might see it as a reduction of pain. Others might see the ability to interact socially, the ability to swallow or get out of bed. Others might see a reduction in fatigue. "

Nevertheless, progression-free survival can be used as an early indicator that researchers are on the right track with a new drug, Ferris said. For example, when an experimental drug can control a tumor, this could give researchers the impetus to conduct larger scale trials.

"You must be wise in your use," concluded Ferris.