Quality of Life Considerations for Patients with Kidney Cancer

Patients with advanced kidney cancer administered a newer first-line therapy may have similar quality of life outcomes (QOL) to patients treated with standard chemotherapy, according to a study published by the Journal of Clinical Oncology.
The recent study specifically compared QOL outcomes between cabozantinib and everolimus.
Cabozantinib is indicated as a first-line treatment for patients with advanced renal cell carcinoma (RCC). In 2016, the FDA approved cabozantinib to treat patients with advanced RCC who were previously treated with anti-angiogenic therapy. The drug is also indicated as a first-line therapy for thyroid cancer.
Everolimus is a chemotherapy that is indicated to treat kidney, pancreatic, breast, and brain cancers. It can also be used as a combination therapy to prevent transplant rejection.
Previous studies have suggested that treatment with cabozantinib may improve response rates and progression free survival compared with everolimus; however, the drug’s impact on QOL was previously unknown, according to the authors.
“It is very common these days to see a new and exciting cancer therapy come along. Often, those new therapies increase the proportion of people whose measurable tumors shrink or delay the average time it takes for the cancer to progress, but they do not necessarily lengthen life itself,” said lead author David Cella, PhD. “In these cases, it becomes critically important to know if those clinical benefits are associated with better quality of life, or worse quality of life, compared to standard available therapy.”
The authors examined adverse events, disease symptoms, and overall well-being among 658 patients with advanced RCC who were randomized to receive treatment with cabozantinib or everolimus. Study participants had all experienced disease progression on previous therapies.
Patients answered questionnaires at baseline and during the study to assess QOL measures.
There was no overall change in QOL between patients treated with cabozantinib or everolimus, according to the study; however, the authors did note that adverse events differed between the drugs.
Although the treatments did not outperform each other in terms of QOL scores, cabozantinib was found to delay time to progression compared with everolimus, according to the study.
The researchers said that this finding suggests cabozantinib may help patients live longer with a stable QOL until RCC progression.
These new results indicate that oncologists should review their treatment approaches for patients with RCC and recommend another therapy when QOL is a concern, according to the authors. 
“In this regard, the quality of life data supports the superiority of cabozantinib over everolimus among people whose kidney cancer has progressed rapidly on prior therapy,” Dr Cella said.

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