Health-related quality of life (HRQoL)
The integral endpoint
HRQoL has emerged as an integral endpoint in clinical trials for advanced cancer and a primary treatment goal.1,2 Patients report significant impacts on QoL that include a range of physical symptoms, such as chronic cough, dyspnea, chest pain, anorexia, fatigue, and weight loss.1 Aside from physical symptoms, HRQoL is a multifaceted concept, which encompasses psychological, emotional, social, cognitive, spiritual beliefs and sexual factors.1,2
HRQoL data provide a measure of symptom severity that may factor into treatment comparisons, influence clinical treatment decision-making, improve patient-clinician communication, and form the basis of key outcome measures in clinical and economic evaluations to ensure efficient allocation of healthcare resources.1,2
Multiple generic and cancer-specific tools have been developed to measure HRQoL in patients:1,2
EORTC QLQ-C30
EORTC QLQ-LC13
EQ-5D
EQ-VAS
FACT-L
Patient-reported HRQoL data facilitate a better understanding of treatment-related adverse events, and provide invaluable insight into frequently under-reported subjective symptoms, such as fatigue and pain.1,2
Finally, as an independent predictive value for therapy response and survival, baseline HRQoL performs better than certain classic tumor symptom endpoints, such as performance status.2,3
C30: Core 30 items; EORTC: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EQ: EuroQol; FACT-L: Functional Assessment of Cancer Therapy-Lung; HRQoL: health-related quality of life; LC13: Lung Cancer 13 questions. QLQ: Quality of Life Questionnaire; VAS: visual analogue scale; 5D: 5 domains.
1. Chouaid C, et al. Health-related quality of life and utility in patients with advanced non–small-cell lung cancer: a prospective cross-sectional patient survey in a real-world setting. J Thorac Oncol. 2013;8: 997–1003.
2. Van Der Weijst L, et al. Health-related quality of life in advanced non-small cell lung cancer: a methodological appraisal based on a systematic literature review. Front Oncol. 2019;9:715.
3. Pilz LR, et al. Statistical considerations and endpoints for clinical lung cancer studies: can progression free survival (PFS) substitute overall survival (OS) as a valid endpoint in clinical trials for advanced non-small-cell lung cancer? Transl Lung Cancer Res. 2012;1:26–35.