Real-world symptoms, disease burden, resource use and quality of life in US patients with advanced renal cell cancer

Future Oncol. 2021 Jun;17(17):2169-2182. doi: 10.2217/fon-2020-1266. Epub 2021 Feb 26.

Abstract

Aim: To assess symptoms, healthcare resource utilization and health-related quality of life in advanced renal cell carcinoma (aRCC) clinical practice. Materials & methods: The USA point-in-time survey of physicians and patients was conducted between February and September 2019. Results: Data were available for 227 patients. Mean (standard deviation) number of symptoms was 3.4 (3.2); differences were observed across International Metastatic RCC Database Consortium risk categories (p < 0.001), with fewer symptoms in favorable-risk patients. Disease burden, measured by greater healthcare resource utilization and worse health-related quality of life, was high, particularly in International Metastatic RCC Database Consortium intermediate- or poor- versus favorable-risk patients. In total, 45 patients (21.6%) were hospitalized due to aRCC within a 6-month period, 35 (16.8%) had one hospitalization and ten (4.8%) experienced ≥2 hospitalizations due to aRCC. Mean (standard deviation) 19-Item Functional Assessment of Cancer Therapy Kidney Symptom Index score was 53.6 (13.2) for this population, significantly lower than the reference value (59.8; p < 0.001). Conclusion: A clear need exists for improved disease management in patients with aRCC.

Keywords: advanced RCC; disease burden; healthcare resource utilization; patient-reported outcomes; real-world treatment.

Plain language summary

Lay abstract Late-stage/advanced renal cell carcinoma (aRCC) is kidney cancer that has spread to other body parts. aRCC is expensive to treat and affects patients in many ways. New treatments have become available, including tyrosine kinase inhibitors and immuno-oncology therapies. The type of treatment recommended depends on the patient’s International Metastatic RCC Database Consortium risk score. This is a way of classifying patients as having a good, intermediate or poor survival risk. We asked physicians questions about their patients such as their age, how long they had aRCC, their treatment and symptoms, and asked patients how aRCC affected their lives, including how often they visited doctors and hospitals. aRCC had the greatest effect on patients with poor-risk scores. Those patients had more symptoms and worse quality of life than patients with intermediate or good risk scores. Treatment also affected patients’ lives, although not as much as risk score. Patients with aRCC need better treatment options to help improve their quality of life.

MeSH terms

  • Aged
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / economics
  • Carcinoma, Renal Cell / pathology
  • Carcinoma, Renal Cell / psychology
  • Cost of Illness*
  • Female
  • Follow-Up Studies
  • Health Resources / statistics & numerical data*
  • Humans
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / economics
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / psychology
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / standards*
  • Prognosis
  • Protein Kinase Inhibitors / therapeutic use*
  • Quality of Life*
  • Survival Rate

Substances

  • Protein Kinase Inhibitors

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