Health-related quality of life in molecular targeted therapy

Abstract

Quality of life (QOL) in medicine has been evaluated as health-related QOL (HRQOL). HRQOL is a component of patient-reported outcomes (PROs). HRQOL is a true clinical endpoint when validated and reliable QOL instruments are used. Clinical trials often evaluated HRQOL as the secondary endpoint. Improvement of progression-free survival (PFS) with improved HRQOL would be clinically meaningful outcome. Recently, several randomized trials have been conducted with QOL as the primary endpoint. A randomized trial of early palliative care (EPC) integrated with standard oncologic care or standard oncologic care alone in patients with metastatic non-small cell lung cancer (NSCLC) showed that EPC significantly improved QOL and mood. Median overall survival (OS) was longer among patients receiving EPC. The data suggests that QOL is highly related to OS and QOL evaluation should be integrated into oncology practice for patients with advanced lung cancer. To improve patient management, effective communication is necessary. Communication skill training (CST) program based on SHARE protocol is effective for both oncologists and patients with cancer. Because physicians tend to concentrate on cancer-related outcomes and often neglect assessments of QOL, tools to evaluate QOL would be useful to improve quality of care in patients with advanced lung cancer.