Productivity, Satisfaction, and HealthRelated Quality of Life in Advanced Renal Cell Carcinoma Patients Receiving 2 or More Lines of Treatment: Results from a United Kingdom (UK) chart review

The humanistic burden associated with advanced renal cell carcinoma (aRCC) in the European population and especially in the United Kingdom (UK) is not well understood. This study aims to describe the work-productivity and quality of life (QOL) among aRCC patients in the UK.

This retrospective chart review enrolled adults diagnosed with aRCC between 12/23/2016 and 05/26/2017, who received at least 2 lines (L) of systemic therapy for aRCC. Patients were excluded if they were enrolled in a cancer treatment–related clinical trial after aRCC diagnosis. Patients who agreed to participate completed a one-time computer-assisted telephone interview composed of the following instruments: Euroqol EQ-5D-5L (index range: 0 [worst] to 1 [best]; visual analog scale [VAS]: 0 [worst] to 100 [best]), Functional Assessment of Chronic Illness Therapy Measurement System (FACT-G Total; range: 0 [worst] to 108 [best]; FACT-G physical, social, and functional well-being dimensions, range: 0 [worst] to 28 [best]), Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19 Total; range: 0 [worst] to 76 [best]), Cancer Therapy Satisfaction Questionnaire (CTSQ; range: 0 [worst] to 100 [best]), and Work Productivity and Activity Impairment (WPAI; range: 0 [best] to 100 [worst]).

A total of 65 patients (mean age 61 years, 60% male, 44% stage IV) were included from 7 sites. Health-related quality of life as measured by the EQ-5D-5L had a mean index of 0.56 (SD 0.37) and VAS of 61.8 (22.7), with over half of patients reporting problems on pain/discomfort (75%) and usual activities (69%) dimensions. The overall mean FACT-G Total score was 71.8 (15.3). For FACT-G domains, functional well-being, which ranged from 0-28, was most affected with a score of 17.12 (SD 6.15) followed by emotional well-being at 15.7 (SD 5.2). The mean FKSI-19 total score was 48.8 (SD 13.2). Mean FKSI-DR-symptoms emotional score was low (1.7 out of 4), indicating a strong impact of symptoms on the patients. CTSQ overall score on satisfaction with the therapy was 82.0 (SD 12.9), with a low score of 5.7 (SD 20.9) for treatment expectation, indicating lack of appropriate perceived quality of treatment. For WPAI, 40% patients were employed and overall work productivity loss was 42.9 (SD 30.0).

There is substantial humanistic burden for patients with aRCC in UK, including diminished health-related quality of life, low satisfaction, and decreased work productivity. New treatment options with increased effectiveness and improved adverse event profiles are warranted to improve these patient-reported outcomes.