Impact of Age on Quality of Life After Immune Checkpoint Inhibitor Treatment for Patients With Lung Cancer

A study found old age to be significantly associated with lower health-related quality-of-life (HRQoL) scores for patients with lung cancer after treatment with an immune checkpoint inhibitor. Older patients with lung cancer also experienced larger declines in specific HRQoL domains after 6 months of immune checkpoint inhibitor treatment. 

“It remains unclear as to whether changes in Health-Related Quality-of-Life are associated with the age of lung cancer patients treated using [immune checkpoint inhibitors],” Erick Suazo-Zepeda, MD, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, and colleagues stated.

This longitudinal cohort study evaluated 151 patients with lung cancer and a mean age of 65.8 (37 to 87) years who had been treated with immune checkpoint inhibitors at the University Medical Center Groningen between 2015 and 2021, regardless of other treatment. Patients were asked to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTCQLQ-C30) at the start of immune checkpoint inhibition and after 6 months. The study’s goal was to evaluate a possible association between age and HRQoL scores and compare the scores of patients who received immune checkpoint inhibitor therapy with normative data of an age-matched non-cancer general population.

The study found an increase in age per 10 years to be associated with a larger decrease in the summary HRQoL score (β = -3.28; 95% confidence interval [CI], -6.42 to -0.14). These decreases were observed in various aspects of the HRQoL score, including physical (β = -4.8; 95% CI, -8.71 to -0.88), cognitive (β = -4.51; 95% CI, -8.24 to -0.78), role functioning (β = -5.41; 95% CI, -10.78 to -0.05), and symptom burden (β = -3.66; 95% CI, -6.6 to -0.73). Smaller negative changes were noted by patients in financial difficulties (β = 6.5; 95% CI, 3.16 to 9.85). The patients who received checkpoint inhibition had HRQoL scores that were lower than those of the general population, with differences most often classified as large and medium.

“HRQoL should not be overlooked in the context of providing [immune checkpoint inhibitor] treatment to older patients, since negative effects experienced can be substantial,” wrote Dr Suazo-Zepeda et al. “The interdisciplinary health teams of lung cancer patients undergoing [immune checkpoint inhibitor] treatment should pay special attention to older patients’ psycho-social support networks to avoid large HRQoL deteriorations,” the authors concluded.

Source:                                        

Suazo-Zepeda E, Vinke PC, Heuvelmans MA, et al. Quality of life after treatment with immune checkpoint inhibitors for lung cancer; the impact of age. Lung Cancer. 2023;176:89-97. doi:10.1016/j.lungcan.2022.12.017