Patient-Reported Outcomes With First-Line Immunotherapy-Based Combination Treatment for Advanced Lung Cancer: A...

Area of Science:

• Oncology
• Immunotherapy
• Patient-Reported Outcomes

Background:

• Advanced lung cancer treatment involves immune checkpoint inhibitors (ICIs).
• Understanding longitudinal symptom trajectories is crucial for managing patient care.
• Electronic patient-reported outcomes (ePRO) offer real-time symptom data.

Purpose of the Study:

• To characterize tumor burden and symptom changes during ICI therapy for advanced lung cancer.
• To analyze symptom trajectories using ePRO data.
• To compare symptom burden between different first-line immunotherapy combinations.

Main Methods:

• Utilized MD Anderson Symptom Inventory-Lung Cancer module and an immune-related adverse event scale for ePRO collection.
• Included 168 patients receiving first-line immunotherapy-based combination treatment.
• Employed linear mixed-effects models to evaluate symptom trajectories and group differences.

Main Results:

• Pre-treatment symptoms included coughing, distress, shortness of breath, disturbed sleep, and pain.
• Lung cancer-related symptoms generally decreased with treatment.
• Immunotherapy-related symptoms (e.g., early satiety, abdominal distension) showed cyclical increases.
• Adding VEGFR-TKIs to ICI + chemotherapy reduced four of the top five immunotherapy-related symptoms.

Conclusions:

• Immunotherapy-based treatments reduced lung cancer-related symptoms in advanced patients.
• Immune-specific symptoms exhibited cyclical exacerbation during treatment.
• Combination therapy with VEGFR-TKIs did not elevate the overall toxicity burden.