QUALITY OF LIFE, FATIGUE, AND DEPRESSION REMAIN UNCHANGED WITH TREATMENT FOR ADVANCED PROSTATE CANCER

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PURPOSE: Cross-sectional studies suggest that men with advanced prostate cancer (PC) treated with androgen receptor pathway inhibitors (ARPI) have lower reported quality of life (QoL). However, the rate of decline in QoL as well as the extent to the decline during treatment remains unclear. Thus, the purpose of this study was to investigate QoL in males with advanced PC initiating ARPI treatment and after 12 and 24 weeks of therapy. METHODS: In this single arm, observational pilot study, men with advanced PC (n = 22, 72.2 ± 8.0 y) initiating ARPI completed patient reported outcomes at baseline, 12 weeks, and 24 weeks. These included Functional Assessment of Cancer Therapy - Prostate (FACT-P), FACT-Bone Pain, Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue, Hospital Anxiety and Depression Scale (HADS), and Godin Leisure-Time Exercise Questionnaire. Data were analyzed using linear mixed models. Mean differences (MD) were calculated as 12- or 24-week follow up - baseline. RESULTS: The majority (73%) of subjects were diagnosed with metastatic hormone sensitive PC (mHSPC) and median time since initial diagnosis was 4.5 months. Subjects were classified as active (53.3 ± 19.6), and this did not change at 12-weeks (MD: 4.6, [-16.4, 25.7], p = 0.669, d = 0.118) and 24-weeks (-6.40, [-27.9, 15.1], p = 0.563, d = 0.133). At baseline, HADS indicated no underlying anxiety (3.3 ± 1.1) nor depression (2.3 ± 0.9). Across 24 wk of ARPI, no changes were observed in anxiety (-0.8, [-4.0, 2.3], p = 0.607, d = 0.116) nor depression (0.07, [-0.7, 0.8], p = 0.865, d = 0.032). FACT-P was unchanged at 12 weeks (0.121, [-3.141, 3.38], p = 0.943, d = 0.085), then tended to improve at 24 weeks (3.1, [-0.2, 6.4], p = 0.075, d = 0.300). FACIT Fatigue scores were unchanged across the intervention (-0.833, [-3.98, 2.31], p = 0.607, d = 0.165). FACT-BP scores remain unchanged across 24 weeks of treatment (1.3, [-0.8, 3.4], p = 0.239, d = 0.200). CONCLUSIONS: Contrary to previous data, ARPI initiation had minimal impact on patient reported outcomes over 12 and 24 weeks of treatment. We hypothesize this is due having a more active and healthier sample which may have had protective effects on mental and physical health.

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