No abstract

The majority of lung cancer patients progressing from conventional therapies are refractory to PD ‐L1/ PD ‐1 blockade monotherapy. Here, we show that baseline systemic CD 4 immunity is a differential factor for clinical responses. Patients with functional systemic CD 4 T cells included all objective responders and could be identified before the start of therapy by having a high proportion of memory CD 4 T cells. In these patients, CD 4 T cells possessed significant proliferative capacities, low co‐expression of PD ‐1/ LAG ‐3 and were responsive to PD ‐1 blockade ex vivo and in vivo . In contrast, patients with dysfunctional systemic CD 4 immunity did not respond even though they had lung cancer‐specific T cells. Although proficient in cytokine production, CD 4 T cells in these patients proliferated very poorly, strongly co‐upregulated PD ‐1/ LAG ‐3, and were largely refractory to PD ‐1 monoblockade. CD 8 immunity only recovered in patients with functional CD 4 immunity. T‐cell proliferative dysfunctionality could be reverted by PD ‐1/ LAG ‐3 co‐blockade. Patients with functional CD 4 immunity and PD ‐L1 tumor positivity exhibited response rates of 70%, highlighting the contribution of CD 4 immunity for efficacious PD ‐L1/ PD ‐1 blockade therapy.

Satisfaction with care among cancer patients treated at the day hospital is high. Nurses play a key and successful role. Age and tumour location revealed stronger relationships with SC. Correlations between SC and quality of life indicate that these concepts are complementary.

The OUT-PATSAT35 RT appears to be a reliable and valid instrument when applied to a sample of Spanish cancer patients. These results are in line with those of the validation study conducted by the authors of the questionnaire.

The OUT-PATSAT35 CT is a reliable and valid instrument when applied to a sample of Spanish cancer patients. These results are in line with those of the validation study conducted by the authors of the questionnaire and with the validation study for Spain of the OUT-PATSAT35 RT.