Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer
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View abstract on PubMed
Summary
This summary is machine-generated.Emotional distress (ED) in cancer patients is linked to poorer outcomes with immune checkpoint inhibitors (ICIs). Addressing ED may improve treatment efficacy for non-small-cell lung cancer.
Area Of Science
- Oncology
- Psychoneuroimmunology
- Cancer Immunology
Background
- Emotional distress (ED), encompassing depression and anxiety, is common in cancer patients.
- Preclinical data suggest ED may suppress antitumor immunity, but clinical evidence linking ED to immune checkpoint inhibitor (ICI) efficacy is limited.
Purpose Of The Study
- To investigate the association between baseline emotional distress and the clinical efficacy of first-line immune checkpoint inhibitors (ICIs) in advanced non-small-cell lung cancer (NSCLC).
Main Methods
- Prospective observational study (STRESS-LUNG cohort 1) of 227 advanced NSCLC patients receiving first-line ICIs.
- Emotional distress assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales at baseline.
- Progression-free survival (PFS), objective response rate (ORR), overall survival (OS), and quality of life (QoL) were evaluated.
Main Results
- Nearly half of patients (48.9%) had baseline ED (PHQ-9 ≥5 and/or GAD-7 ≥5).
- Patients with ED had significantly shorter median PFS (7.9 vs. 15.5 months, P=0.002) and lower ORR (46.8% vs. 62.1%, P=0.022).
- ED was associated with reduced 2-year OS (46.5% vs. 64.9%, P=0.016) and poorer QoL. Exploratory analysis showed elevated cortisol in the ED group correlated with worse survival.
Conclusions
- Baseline emotional distress is associated with significantly worse clinical outcomes in advanced NSCLC patients treated with first-line ICIs.
- These findings underscore the importance of assessing and managing emotional distress in cancer patients undergoing immunotherapy.
- Targeting ED may represent a novel strategy to enhance ICI efficacy and improve patient survival and quality of life.
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