Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents- a real-world cross-sectional study from Switzerland (SAKK 95/16).

Abstract

BACKGROUND:

Bone-targeted agents (BTAs) are widely used in the management of patients with bone metastases from solid tumors. Knowledge of the impact of their routine care use on patient-reported pain and bone pain-related quality of life (QoL) is limited.

METHODS:

This real world, cross-sectional study enrolled patients over a 3-month period through oncologists across Switzerland. Patients were ≥ 18 years, had solid tumors and at least one bone metastasis, and received routine care for bone metastases. Physicians provided data on BTA-related practices, risk of bone complications and BTA regimen. Patients completed questionnaires about pain (BPI-SF), general and bone pain-related QoL (FACT-G, FACT-BP) and treatment satisfaction (FACIT-TS-G).

RESULTS:

Eighteen sites recruited 417 patients. Based on the FACT-BP, 42% of the patients indicated not having bone pain. According to the BPI-SF, 28% reported no, 43% mild, 14% moderate, and 15% severe pain, respectively. Patients not treated with a BTA had better overall QoL (FACT-G: p = 0.031) and bone pain-related QoL (FACT-BP, p = 0.007) than those treated with a BTA. All pain and other QoL scales did not differ between groups. Patients perceived at 'low risk of bone complications' by their physician not receiving a BTA reported less pain and better QoL than those considered at 'low risk' but receiving BTA treatment or those considered at 'high risk' regardless of BTA treatment. Overall satisfaction with the treatment was good; almost 50% of patients reporting that they were completely satisfied.

CONCLUSIONS:

Overall, pain and QoL did not differ according to BTA treatment or physicians' risk perception. Patient with low risks not receiving BTA treatment reported least pain and highest QoL scores. These results may suggest that treating physicians assess bone complication risk appropriately and treat patients accordingly, but they need to be confirmed by objective determination of longitudinal skeletal complication risk.

• Authors: Karin Ribi, Beat Thürlimann, Corinne Schär, Daniel Dietrich, Richard Cathomas, Ursina Zürrer-Härdi, Thomas von Briel, Sandro Anchisi, Pierre Bohanes, Veronika Blum, Philippe von Burg, Meinrad Mannhart, Clemens B Caspar, Roger von Moos, Michael Mark
• Journal: BMC cancer (BMC Cancer) Vol. 21 Issue 1 Pg. 182 (Feb 19 2021) ISSN: 1471-2407 [Electronic] England
• PMID: 33607966 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Chemical References

• Bone Density Conservation Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Bone Density Conservation Agents (adverse effects, therapeutic use)
• Bone Neoplasms (drug therapy, epidemiology, secondary)
• Cancer Pain (epidemiology)
• Cross-Sectional Studies
• Female
• Humans
• Male
• Middle Aged
• Neoplasms (drug therapy, epidemiology, pathology)
• Quality of Life
• Surveys and Questionnaires
• Switzerland (epidemiology)