Assessing health-state utility values in patients with metastatic colorectal cancer: a utility study in the United Kingdom and the Netherlands

Int J Colorectal Dis. 2014 Oct;29(10):1203-10. doi: 10.1007/s00384-014-1980-1. Epub 2014 Aug 1.

Abstract

Purpose: This study aimed to elicit EuroQol Quality of Life 5-Dimensions (EQ-5D) utility values from patients with second-line metastatic colorectal cancer (mCRC) pre- and post-progression.

Methods: A cross-sectional study was conducted in five hospitals in the Netherlands and the UK. Patients with mCRC were eligible if prescribed a second or subsequent line of therapy or best supportive care (BSC), received prior oxaliplatin in first-line therapy, and had Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-2 at second-line initiation. Patients completed the EuroQol Quality of Life 5-Dimensions 3-levels (EQ-5D-3L) questionnaire and were categorized as pre- or post-progression. Chart data including patient demographics, clinical history, prior/current treatments and serious adverse events (SAEs) were collected. Mean utilities were estimated; uni- and multivariate analyses were conducted.

Results: Seventy-five patients were enrolled; 42 were pre-progression defined as second line or third line following an AE on second line and 33 were post-progression defined as third or subsequent therapy lines or BSC. Patient/disease characteristics and number of SAEs were similar between cohorts. Mean utility scores were 0.741 (SD = 0.230) and 0.731 (SD = 0.292) for pre- and post-progression cohorts, respectively. Compared to pre-progression, more patients reported increased anxiety/depression (36 vs. 12 %) and fewer problems with daily activities (64 vs. 38 %) post-progression. More patients pre-progression were on active treatment at enrolment (83 vs. 42 %) compared to post-progression.

Conclusions: This is the first real-world study to collect utilities for patients with second-line mCRC pre- and post-disease progression. Utility values were similar pre- and post-progression. To further explore the effect of radiological progression on utilities, longitudinal research is required that includes patients in palliative care centres.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Antineoplastic Agents / therapeutic use
  • Anxiety / etiology
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / psychology*
  • Colorectal Neoplasms / secondary
  • Cross-Sectional Studies
  • Depression / etiology
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin
  • Pain / etiology
  • Palliative Care
  • Quality of Life*
  • Surveys and Questionnaires*
  • United Kingdom

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Oxaliplatin