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Patient-Reported Outcomes From Patients Receiving Immunotherapy or Chemoimmunotherapy for Metastatic Non-Small-Cell
Laurie E Steffen McLouth1, Thomas W Lycan2, Beverly J Levine3
1Department of Behavioral Science, Markey Cancer Center, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY.
Metastatic non-small-cell lung cancer patients receiving immunotherapy reported significant symptom burden, particularly fatigue and pain, which was worse in those with poor performance status (ECOG PS 2/3). Closer monitoring of symptoms is crucial for these patients.
Area of Science:
- Oncology
- Clinical Trials
- Patient-Reported Outcomes
Background:
- Immunotherapy and chemoimmunotherapy trials for metastatic non-small-cell lung cancer (mNSCLC) often exclude patients with poor performance status (PS).
- Existing patient-reported measures may not fully capture immunotherapy-related symptoms.
- This study addresses quality of life and symptom burden in mNSCLC patients receiving immunotherapy in real-world clinical practice.
Purpose of the Study:
- To describe quality of life and symptom burden in mNSCLC patients undergoing immunotherapy.
- To examine symptom burden based on Eastern Cooperative Oncology Group performance status (ECOG PS) and age.
Main Methods:
- Sixty mNSCLC patients receiving immunotherapy or chemoimmunotherapy between 2017-2018 were analyzed.
- Patients completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the National Cancer Institute Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE).
- Analyses compared scores by ECOG PS (0/1 vs. 2/3) and age (<70 vs. ≥70 years).
Main Results:
- The mean EORTC-QLQ-C30 global health score was 62.6, with fatigue, insomnia, dyspnea, and financial concerns being the most reported symptoms.
- Patients with ECOG PS 2/3 reported worse global health and pain.
- PRO-CTCAE data revealed 20-40% of patients experienced moderate gastrointestinal, respiratory, dermatologic, arthralgia, or myalgia symptoms, with higher pain scores in ECOG PS 2/3 patients.
Conclusions:
- While global health in clinical practice mirrors trial data, PRO-CTCAE indicates a higher prevalence of symptoms.
- Patients with ECOG PS 2/3 experience a greater symptom burden and require closer monitoring.
- These findings highlight the importance of comprehensive symptom assessment in mNSCLC patients receiving immunotherapy.
