The impact of CDK4/6 inhibitors on the quality of life of working-age women with metastatic breast cancer: a population-based cohort study from Portugal

Abstract

Background Breast cancer frequently leads to reduced work capacity and increased absenteeism among working-age women diagnosed with this condition. In this study, we aimed to assess the effect of CDK4/6i combined with aromatase inhibitors (AIs) or fulvestrant on quality of life (QoL) and work activity in a cohort of Portuguese patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) metastatic breast cancer who started this treatment regimen. Methods This unicentric prospective observational cohort study was conducted in 35 Portuguese women with stage IV HR+/HER2- breast cancer receiving CDK4/6i combined therapy. The objectives of the study were evaluated using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 version 3 (QLQ-C30) and the breast cancer-specific Questionnaire (EORTC QLQ-BR23), and the Work Productivity and Activity Impairment questionnaire - General Health (WPAI:GH) questionnaires at four different time points throughout treatment. Results The results obtained revealed a significant improvement in EORTC QLQ-C30 score from baseline in emotional functioning, social functioning, pain, dyspnea, insomnia, and financial difficulties, as well as in future perspective and breast symptoms, as assessed by EORTC QLQ-BR23 score. However, a significant deterioration from baseline in systemic therapy side effects was also observed. Despite the limitations regarding the cohort size, an increase in work absenteeism was also observed, as determined by WPAI:GH scores. This can possibly be attributed to pain-related bone metastases observed in those patients. Conclusions To the best of our knowledge, this is the first study to assess the impact of combined CDK4/6i therapy on the QoL and work activity of Portuguese patients with metastatic breast cancer. Our results indicate that although patients’ QoL did not appear to be affected, there was a significant decrease in work activity, as evidenced by preliminary results of the increased rate on work absenteeism.