Standardized area under the curve of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score over the maintenance period
Time frame: After 4 weeks of treatment until week 16
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. The validated QLQ-C30 summary score is calculated as mean score of items. A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Change of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30 symptom summary score from baseline to summary score over the maintenance period
Time frame: From treatment start until week 16
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. The validated QLQ-C30 summary score is calculated as mean score of items. A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Symptom scales of European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
A high score for a symptom scale / item (fatigue, nausea and vomiting, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea) represents a high level of symptomatology / problems. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Global quality of life of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. The validated QLQ-C30 summary score is calculated as mean score of items. A high score for the global health status (overall health during the past week) and global QoL (overall quality of life during the past week) represents a high QoL. Scores: 1 - 7, 1 = very poor and 7 = excellent. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Functional scales of the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ)-C30
Time frame: At baseline and 2-weekly until end of treatment at week 18
The European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ) is an integrated system for assessing the health-related quality of life (QoL) of cancer patients participating in international clinical trials. A high score for a functional scale (physical functioning, role functioning, cognitive functioning, emotional functioning, social functioning) represents a high / healthy level of functioning. Scores for individual items: "Not at All" = 1 point, "A Little" = 2 points, "Quite a Bit" = 3 points, "Very Much" = 4 points. A linear transformation is used to standardize the raw score, so that overall scores range from 0 to 100.
Mean change from baseline of the Glasgow Prognostic Score
Time frame: At baseline and at end of treatment at week 16
Change of serum levels of the score-defining biomarkers C-reactive protein (CRP) and albumin. Prognostic scores; 0 (CRP ≥ 10 mg/l), 1 (CRP \> 10 mg/l and albumin ≥ 35 g/l), 2 CRP \> 10 mg/l and albumin \< 35g/l). Score 0 indicates good prognosis, score 1 intermediate prognosis and score 2 poor prognosis.
Amount of concomitant medication taken
Time frame: From baseline until end of treatment at week 18
Special focus on antiemetic, psychotropic and pain medication
Mean time to critical weight-loss (5%)
Time frame: From baseline until end of treatment at week 16
Assessed with a standard scale
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Lean body mass (LBM)
Time frame: At baseline and at end of treatment at week 16
Mean change of Lean body mass (LBM = Fat free mass FFM) kg
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Total body water (TBW)
Time frame: At baseline and at end of treatment at week 16
Mean change of Total body water (TBW) kg
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Fat mass (FM)
Time frame: At baseline and at end of treatment at week 16
Mean change of Fat mass (FM) kg
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Body cell mass (BCM)
Time frame: At baseline and at end of treatment at week 16
Mean change of Body cell mass (BCM) kg
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Extracellular mass (EM)
Time frame: At baseline and at end of treatment at week 16
Mean change of Extracellular mass (ECM) kg
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Phase angle (PA)
Time frame: At baseline and at end of treatment at week 16
Mean change of Phase angle (PA); Phase Angle has long been linked to nutritional status. This marker is fast becoming recognised as a global health marker in total body health assessment. A higher Phase Angle could mean an increase in muscle mass (body cell mass) or a decrease in fluid, either from recovery from infection or injury (a good thing!) or a decrease in fluid from dehydration (a bad thing!). A loss of fat could also increase Phase Angle. A lower Phase Angle could mean a loss of muscle mass (a bad thing), or an increase of fluid (rehydrating which is a good thing, or sign of inflammation or infection - a bad thing), or gaining fat (which could be a good or bad thing depending on your state of health). Phase Angle is a direct measurement, (not a calculation using equations) of the cell membrane.
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Resistance (Rz)
Time frame: At baseline and at end of treatment at week 16
Mean change of Resistance (Rz), unit ohm; the resistance reflects the water or fluid in the body
Mean changes from baseline for Bioelectrical Impedance Analysis (BIA) parameter Reactance(Xc)
Time frame: At baseline and at end of treatment at week 16
Mean change of Reactance (Xc), unit ohm; reactance reflects the body cell mass.
Mean change from baseline of muscle strength
Time frame: At baseline and at end of treatment at week 16
To assess physical strength of patient's handgrip strength will be measured prior and after study treatment using a hydraulic hand dynamometer; mean value of three consecutive measurements will be documented
Proportion of patients not adhering to individual baseline chemotherapy regimen
Time frame: From baseline until end of treatment at week 18
Percentage of patients who do not receive full dose of planned chemotherapy regimen and/or within scheduled time frame (interruption or delay)
Chemotherapeutic dose intensity over the treatment period of 18 weeks
Time frame: From baseline until end of treatment at week 18
The total amount of applied chemotherapy over the study treatment phase is documented
Frequency and severity of (serious) adverse events (S)AE
Time frame: From baseline until safety visit at week 22
Assessed with Common Terminology Criteria for Adverse Events (NCI-CTCAE V5.0)
Incidence of adverse drug reactions (ARs)
Time frame: From baseline until safety visit at week 22
Frequency and severity of ARs
Progression-free survival (PFS)
Time frame: From treatment start until the date of first documented progression or death from any cause assessed up to week 22
PFS in months; ; patients will be asked to agree on collection of data regarding PFS also after end of trial
Overall survival (OS)
Time frame: From treatment start until death from any cause assessed up to week 22
OS in months; ; patients will be asked to agree on collection of data regarding PFS also after end of trial