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Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation

SIMPLE SUMMARY: NSCLC patients with a targetable driver mutation are entitled to receive targeted therapy. Targeted therapy is usually less toxic than chemotherapy and immunotherapy. However, low-grade side effects are common and often chronic, which could also negatively impact a patient’s health-r...

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Autores principales: Billingy, Nicole E., Tromp, Vashti N. M. F., van den Hurk, Corina J. G., Becker-Commissaris, Annemarie, Walraven, Iris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428358/
https://www.ncbi.nlm.nih.gov/pubmed/34503092
http://dx.doi.org/10.3390/cancers13174282
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author Billingy, Nicole E.
Tromp, Vashti N. M. F.
van den Hurk, Corina J. G.
Becker-Commissaris, Annemarie
Walraven, Iris
author_facet Billingy, Nicole E.
Tromp, Vashti N. M. F.
van den Hurk, Corina J. G.
Becker-Commissaris, Annemarie
Walraven, Iris
author_sort Billingy, Nicole E.
collection PubMed
description SIMPLE SUMMARY: NSCLC patients with a targetable driver mutation are entitled to receive targeted therapy. Targeted therapy is usually less toxic than chemotherapy and immunotherapy. However, low-grade side effects are common and often chronic, which could also negatively impact a patient’s health-related quality of life (HRQOL). HRQOL in NSCLC patients with and without a targetable driver mutation is thus likely to be different. To optimize clinical decision making for individualized treatment in patients with metastatic NSCLC, it is necessary to understand differences in HRQOL and survival outcomes between patients with and without a targetable driver mutation. In this study, we show that NSCLC patients with a targetable driver mutation have favorable HRQOL over time compared to patients without a targetable driver mutation. Furthermore, clinically relevant HRQOL declines over time were significantly associated with worse survival. HRQOL can therefore play an important role in shaping patients’ expectations of their prognosis. ABSTRACT: Background: The aim of this study is to compare long-term health-related quality of life (HRQOL) and survival in metastatic NSCLC patients with (M+) and without (M−) a targetable driver mutation. Methods: An observational study was performed within the prospective SYMPRO-lung study (NL7897). HRQOL questionnaires were completed at baseline, 15 weeks, and 6 months. Generalized estimating equations (GEE) were used to assess clinically significant declines in HRQOL (>10 points) over time. Kaplan–Meier survival curves were plotted for both progression-free survival (PFS) and overall survival (OS). Results: 81 metastatic NSCLC patients were included (M+ patients; 16 (20%)). M+ patients had a significantly better global HRQOL (mean difference 12.8, ES 0.61), physical functioning (mean difference 13.4, ES 0.63), and less appetite loss (mean difference 23.1, ES 0.73) at 15 weeks of follow-up compared to M− patients. Patients with a clinically relevant decline in HRQOL at 6 months of follow-up had a significantly shorter PFS (5 months vs. 12 months, p-value < 0.001) and OS (11 months vs. 16 months, p-value 0.002). Conclusions: M− NSCLC patients have less favorable HRQOL over time compared to M+ patients. Furthermore, clinically relevant HRQOL declines over time were significantly associated with worse survival. HRQOL can therefore play an important role in in shaping patients’ expectations of their prognosis.
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spelling pubmed-84283582021-09-10 Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation Billingy, Nicole E. Tromp, Vashti N. M. F. van den Hurk, Corina J. G. Becker-Commissaris, Annemarie Walraven, Iris Cancers (Basel) Article SIMPLE SUMMARY: NSCLC patients with a targetable driver mutation are entitled to receive targeted therapy. Targeted therapy is usually less toxic than chemotherapy and immunotherapy. However, low-grade side effects are common and often chronic, which could also negatively impact a patient’s health-related quality of life (HRQOL). HRQOL in NSCLC patients with and without a targetable driver mutation is thus likely to be different. To optimize clinical decision making for individualized treatment in patients with metastatic NSCLC, it is necessary to understand differences in HRQOL and survival outcomes between patients with and without a targetable driver mutation. In this study, we show that NSCLC patients with a targetable driver mutation have favorable HRQOL over time compared to patients without a targetable driver mutation. Furthermore, clinically relevant HRQOL declines over time were significantly associated with worse survival. HRQOL can therefore play an important role in shaping patients’ expectations of their prognosis. ABSTRACT: Background: The aim of this study is to compare long-term health-related quality of life (HRQOL) and survival in metastatic NSCLC patients with (M+) and without (M−) a targetable driver mutation. Methods: An observational study was performed within the prospective SYMPRO-lung study (NL7897). HRQOL questionnaires were completed at baseline, 15 weeks, and 6 months. Generalized estimating equations (GEE) were used to assess clinically significant declines in HRQOL (>10 points) over time. Kaplan–Meier survival curves were plotted for both progression-free survival (PFS) and overall survival (OS). Results: 81 metastatic NSCLC patients were included (M+ patients; 16 (20%)). M+ patients had a significantly better global HRQOL (mean difference 12.8, ES 0.61), physical functioning (mean difference 13.4, ES 0.63), and less appetite loss (mean difference 23.1, ES 0.73) at 15 weeks of follow-up compared to M− patients. Patients with a clinically relevant decline in HRQOL at 6 months of follow-up had a significantly shorter PFS (5 months vs. 12 months, p-value < 0.001) and OS (11 months vs. 16 months, p-value 0.002). Conclusions: M− NSCLC patients have less favorable HRQOL over time compared to M+ patients. Furthermore, clinically relevant HRQOL declines over time were significantly associated with worse survival. HRQOL can therefore play an important role in in shaping patients’ expectations of their prognosis. MDPI 2021-08-25 /pmc/articles/PMC8428358/ /pubmed/34503092 http://dx.doi.org/10.3390/cancers13174282 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Billingy, Nicole E.
Tromp, Vashti N. M. F.
van den Hurk, Corina J. G.
Becker-Commissaris, Annemarie
Walraven, Iris
Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title_full Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title_fullStr Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title_full_unstemmed Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title_short Health-Related Quality of Life and Survival in Metastasized Non-Small Cell Lung Cancer Patients with and without a Targetable Driver Mutation
title_sort health-related quality of life and survival in metastasized non-small cell lung cancer patients with and without a targetable driver mutation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428358/
https://www.ncbi.nlm.nih.gov/pubmed/34503092
http://dx.doi.org/10.3390/cancers13174282
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