Health-related quality of life in cancer patients treated with immune checkpoint inhibitors in randomised controlled trials: A systematic review and meta-analysis

Boutros, Andrea; Bruzzone, Marco; Tanda, Enrica T.; Croce, Elena; Arecco, Luca; Cecchi, Federica; Pronzato, P.; Ceppi, Marcello; Lambertini, Matteo; Spagnolo, Francesco

doi:10.1016/j.ejca.2021.10.005

Cited by 23 publications

(21 citation statements)

References 42 publications

(55 reference statements)

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“…Treatment with ICI delayed clinical deterioration over standard chemotherapy in Global Health Status/QoL EORTC QLQ-C30 (hazard ratio [HR] 0.81; 95% confidence interval [CI], 0.74–0.89), and in both EQ-5D utility index (HR 0.65; 95% CI, 0.52–0.82) and EQ-5D visual analogue scale (VAS; HR 0.70; 95% CI, 0.61–0.80). [45] The difference in mean change between the ICI-treated group and the chemotherapy-treated group was 5.82 (95% CI, 4.11–7.53), in favor of ICIs. [45] Similarly, in the EQ-5D, the mean change differences favored treatment with ICIs in both utility index and VAS, with differences of 0.05 (95% CI, 0.03–0.07) and 5.41 (95% CI, 3.39–7.43), respectively.…”

Section: Discussionmentioning

confidence: 95%

“… [45] The difference in mean change between the ICI-treated group and the chemotherapy-treated group was 5.82 (95% CI, 4.11–7.53), in favor of ICIs. [45] Similarly, in the EQ-5D, the mean change differences favored treatment with ICIs in both utility index and VAS, with differences of 0.05 (95% CI, 0.03–0.07) and 5.41 (95% CI, 3.39–7.43), respectively. [45] …”

Section: Discussionmentioning

confidence: 95%

“…Boutros et al. [45] conducted a systematic review and meta-analysis to compare PROs between ICIs (or ICIs plus chemotherapy) with standard chemotherapy in patients with advanced solid tumors. ICIs were associated with higher levels of QoL and longer time to clinical deterioration on several PRO scales compared with chemotherapy in different types of solid tumors.…”

Section: Discussionmentioning

confidence: 99%

“…The co-primary endpoints were time from baseline to first deterioration in PROs, defined as the time from baseline to the first clinically significant deterioration in PROs, and the changes in PROs from baseline to follow-up between ICI and chemotherapy treatment groups. [45] 17 randomized trials of ICIs versus chemotherapy were included in the analysis. Treatment with ICI delayed clinical deterioration over standard chemotherapy in Global Health Status/QoL EORTC QLQ-C30 (hazard ratio [HR] 0.81; 95% confidence interval [CI], 0.74–0.89), and in both EQ-5D utility index (HR 0.65; 95% CI, 0.52–0.82) and EQ-5D visual analogue scale (VAS; HR 0.70; 95% CI, 0.61–0.80).…”

Section: Discussionmentioning

confidence: 99%

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Analysis of patient reported outcomes included in the registrational clinical trials of nivolumab for advanced non-small cell lung cancer

Zaim

Redekop

Groot

2022

Translational Oncology

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Analysis of patient reported outcomes included in the registrational clinical trials of nivolumab for advanced non-small cell lung cancer

Zaim

Redekop

Groot

2022

Translational Oncology

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“…Second, the development of adjuvant or neo-adjuvant settings is of interest and deserves further insight. All in all, while the effectiveness of ICIs in CRC is undisputed, one should also keep in mind that these agents have demonstrated remarkable effectiveness in many other malignancies, as pointed out in recent reviews [25].…”

Section: Interpretation Of the Survival Datamentioning

confidence: 99%

Efficacy of Immune Checkpoint Inhibitors in Patients with Mismatch Repair-Deficient or Microsatellite Instability-High Metastatic Colorectal Cancer: Analysis of Three Phase-II Trials

Cancanelli¹,

Rivano²,

Spazio³

et al. 2021

Cureus

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Programmed cell death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) inhibitors are increasingly used in a variety of solid tumors. In patients with DNA mismatch repair-deficient (dMMR)/microsatellite instability-high (MSI-H) metastatic colorectal cancer, their efficacy has been demonstrated in recently published phase-II trials. However, an indirect comparison of effectiveness between pembrolizumab, nivolumab, and nivolumab+ipilimumab is not yet available.After a standard literature search, we analyzed four overall survival (OS) curves from three phase-II trials. Individual patient data were reconstructed from each curve using a specific web-based technique (Shiny method). Indirect statistical comparisons were made based on hazard ratio (HR) and restricted mean survival time (RMST).Nivolumab+ipilumumab had a better HR compared with pembrolizumab (0.65, 95% confidence interval [CI], 0.43 to 1.002, p=0.051); the difference being close to statistical significance. In the analysis based on RMST, the combination of nivolumab+ipilimumab showed a significantly longer OS than pembrolizumab (improvement in RMST, 1.08 mos; 95%CI, 0.11 to 2.06; p=0.029). The other two pairwise differences in RMST (nivolumab vs. pembrolizumab and nivolumab+ ipilimumab vs. nivolumab) had a smaller magnitude (0.25 mos, 95%CI, -0.99 to 1.48, and 0.84 mos, 95%CI, -0.40 to 2.07, respectively) and were far from statistical significance.Our results favoring the combination of nivolumab+ipilimumab in metastatic colorectal cancer must be viewed with caution owing to the indirect nature of our statistical comparisons. With this limitation in mind, the magnitude of the incremental benefit for the above combination treatment was estimated to be around one month over a follow-up of 15 months.

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Associations between age and patient‐reported outcomes, emergency department visits, and hospitalizations among lung cancer patients receiving immune checkpoint inhibitors

Fleszar‐Pavlovic,

Natori,

Moreno

et al. 2024

Psycho-Oncology

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ObjectiveImmune checkpoint inhibitors (ICIs) for lung cancer (LC) treatment have a more favorable safety profile and improved patient reported outcomes (PROs) compared to chemotherapy, suggesting that ICIs are advantageous for older populations. The impact of ICIs on PROs, clinical outcomes, and age in LC patients remains to be established. We examined associations between age and PROs, emergency department (ED) visits, and hospitalizations in LC patients receiving ICIs.MethodsWe performed retrospective analyses via My Wellness Check (MWC), an assessment and triage electronic medical record (EMR) integrated platform in LC patients receiving ICIs. Demographics, clinical characteristics, ED visits, and hospitalizations were extracted via EMR. Patient reported outcomes (PROMIS® anxiety, depression, fatigue, pain, physical function), and health‐related quality of life (HRQOL; FACT‐G7), were collected via MWC. We classified age into three categories (<65, 65–74, ≥75). Multiple regressions examined associations between PROs and age. Cox proportional hazards regressions assessed cumulative ED visits and hospitalizations.ResultsAmong LC patients (N = 190) receiving ICIs, patients ≥75 had lower depression (β = −5.80, p = 0.01) and higher HRQOL (β = 2.47, p = 0.05) compared with patients <65. Relative to patients <65, patients 65–74 had lower anxiety (β = −3.31, p = 0.05) and pain (β = −4.18, p = 0.03). Patients 65–74 and ≥ 75 had lower risk of an ED visit (adjusted hazards ratio [aHR] = 0.45, p = 0.05 and aHR = 0.21, p = 0.05, respectively) and patients 65–74 had lower risk of hospitalization (aHR = 0.36, p = 0.02) relative to patients <65.ConclusionsOlder LC patients (65–74; ≥75) have more favorable PROs and lower risk for negative clinical outcomes than younger (<65) patients.

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Health-related quality of life in cancer patients treated with immune checkpoint inhibitors in randomised controlled trials: A systematic review and meta-analysis

Cited by 23 publications

References 42 publications

Analysis of patient reported outcomes included in the registrational clinical trials of nivolumab for advanced non-small cell lung cancer

Analysis of patient reported outcomes included in the registrational clinical trials of nivolumab for advanced non-small cell lung cancer

Efficacy of Immune Checkpoint Inhibitors in Patients with Mismatch Repair-Deficient or Microsatellite Instability-High Metastatic Colorectal Cancer: Analysis of Three Phase-II Trials

Associations between age and patient‐reported outcomes, emergency department visits, and hospitalizations among lung cancer patients receiving immune checkpoint inhibitors

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