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Quality of life in late-stage cancer patients on immune checkpoint inhibitor therapy
Background
Immune checkpoint inhibitors are a successful therapy for cancer patients and patient related outcomes compared with cytotoxics. Unfortunately Immune checkpoint inhibitors (ICI) can have unpredictable toxicities that have a severe impact on Health-related Quality of life and may lead to treatment withdrawal. This study attempts to further characterise patient’s quality of life on these treatments and identify any trends in any patient groups.
Methods
17 patients with late-stage cancer who are receiving ICI in Bons Secours Hospital were recruited. Completed Functional Assessment of Cancer Therapy- Immune Checkpoint Modulator (FACT-ICM) quality of life questionnaires were collected and scored. Patient electronic records were reviewed for all other outcome measures. A higher score indicates a higher quality of life. Patients can receive a score from 0 to 208. Patient electronic records were reviewed for all other outcome measures. Outcome measures: Quality of Life score, Side effects graded by NCI-CTCAE, best clinical response by CT scan using RECIST criteria, Age, Gender, Current treatment, ECOG status, comorbidities, Cancer type and grade. Time since first and last immune checkpoint inhibitor (if patient withdrew from treatment).
Results
FACT-ICM scores had a Mean of 168.88 ± 18.398. Patients were grouped and compared according to their patient’s factors to see if this affected their FACT-ICM scores. Patients on concurrent chemotherapy had a mean FACT-ICM score of 157.7 whilst patients not on chemotherapy had a mean score of 175.0. At this sample size no statistically significant trends were observed between quality of life and other patient factors. Whilst on ICI therapy, a lower quality of life score appears to be linked to poor clinical response, presence of autoimmune comorbidities, high ECOG status, age and concurrent chemotherapy.
Conclusions
Patient factors affect the quality of life of a patient on ICI. Further research with more patients recruited is needed for greater statistical power to understand the relationships between quality of life and other patient factors whilst on immune checkpoint inhibitors for late-stage cancer. Chemotherapy should only be used when unavoidable for a brief period in combination.
Legal entity responsible for the study
The authors.
Funding
Dr Brian Bird (Senior Author).
Disclosures
D. Bird: Advisory / Consultancy: Roche, Astra Zeneca, BMS, Takeda, MSD, Servier; Research grant / Funding (self): Roche; Travel / Accommodation / Expenses: Ipsen. All other authors have declared no conflicts of interest.
