Patient-Reported Symptom and Symptom Clusters During Immune Checkpoint Inhibitor Therapy for Cancer Patients: A...

Area of Science:

• Oncology
• Clinical Therapeutics
• Patient-Reported Outcomes

Background:

• Immune checkpoint inhibitors (ICIs) offer promising cancer treatment outcomes but induce unique immune-related adverse events (irAEs).
• Assessing symptom burden is crucial for managing ICI toxicities, with Patient-Reported Outcomes (PROs) vital for capturing nuanced patient experiences.
• Symptom clusters, groups of interrelated symptoms, are understudied in the context of ICI therapy.

Purpose of the Study:

• To identify and characterize symptom clusters in cancer patients undergoing ICI therapy.
• To explore factors influencing symptom burden and its relationship with quality of life.

Main Methods:

• A cross-sectional survey of 213 cancer patients receiving ICI therapy at Guang'anmen Hospital.
• Utilized validated PRO tools for symptom assessment, quality of life, and interference.
• Employed exploratory factor analysis to identify symptom clusters and multiple linear regression to analyze influencing factors.

Main Results:

• Five distinct symptom clusters were identified: emotion-function, respiratory, autonomic nerve dysfunction, mucosa-related, and skin-related.
• Fatigue and dry mouth were prevalent symptoms; fatigue showed the highest incidence of moderate to severe cases.
• Poor performance status and early treatment phase (≤3 months) correlated with higher symptom burden, which negatively impacted quality of life.

Conclusions:

• Cancer patients on ICI therapy experience multi-faceted symptom clusters with potential distinct biological underpinnings.
• Early identification and mechanism-based management of these symptom clusters are essential for mitigating treatment toxicities.
• Further research is needed to refine understanding and management strategies for ICI-related symptom clusters.