Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors
Background Immune checkpoint inhibitors (CIs) have revolutionized treatment of advanced melanoma, leading to an emerging population of long-term survivors. Survivors’ quality of life (QOL) and symptom burden are poorly understood. We set out to evaluate symptom burden and QOL in patients with advanc...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-05-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/8/1/e000260.full |
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| author | Michael A Postow Maha Mamoor Jessica A Lavery Shrujal S Baxi Niloufer Khan Jun J Mao Lauren J Rogak Robert Sidlow Bridgette Thom Jedd A Wolchok Deborah Korenstein |
| author_facet | Michael A Postow Maha Mamoor Jessica A Lavery Shrujal S Baxi Niloufer Khan Jun J Mao Lauren J Rogak Robert Sidlow Bridgette Thom Jedd A Wolchok Deborah Korenstein |
| author_sort | Michael A Postow |
| collection | DOAJ |
| description | Background Immune checkpoint inhibitors (CIs) have revolutionized treatment of advanced melanoma, leading to an emerging population of long-term survivors. Survivors’ quality of life (QOL) and symptom burden are poorly understood. We set out to evaluate symptom burden and QOL in patients with advanced melanoma alive more than 1 year after initiating CI therapy.Methods Cross-sectional surveys, accompanied by chart review of patients with advanced melanoma treated with CIs at Memorial Sloan Kettering Cancer Center, completed therapy, and were alive >1 year after treatment initiation. Surveys were administered between February and August 2018. Surveys included: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, EuroQOL, items from Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events and Fatigue Severity Scale.Results We included 90 patients. The most common CI regimens were ipilimumab plus nivolumab (53%) and pembrolizumab (41%); most patients (71%) were not treated in clinical trials. Median time from CI therapy initiation was 40 months and from last dose was 28 months. Fatigue was reported by 28%, with higher fatigue scores in women than men; 12% reported difficulty sleeping. Aching joints (17%) and muscles (12%) were fairly common. Level of functioning was generally high. Overall QOL was excellent though 40% reported ‘some or moderate’ problems with anxiety/depression and 31% with pain/discomfort.Conclusions After CI therapy, long-surviving advanced melanoma patients commonly report fatigue but otherwise have moderate symptom burden and good QOL. Ensuring appropriate symptom management will optimize clinical outcomes for these patients. |
| format | Article |
| id | doaj-art-5312ac9aae874a10a0c06330b4c02363 |
| institution | Kabale University |
| issn | 2051-1426 |
| language | English |
| publishDate | 2020-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-5312ac9aae874a10a0c06330b4c023632024-11-08T16:45:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-05-018110.1136/jitc-2019-000260Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitorsMichael A Postow0Maha Mamoor1Jessica A Lavery2Shrujal S Baxi3Niloufer Khan4Jun J Mao5Lauren J Rogak6Robert Sidlow7Bridgette Thom8Jedd A Wolchok9Deborah Korenstein1013 Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USAresearch data analyst2 Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA3 Flatiron Health Inc, New York, New York, USA2 Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USAchief2 Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA2 Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA1 Memorial Sloan Kettering Cancer Center, New York, New York, USA2 Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USAchief attendingBackground Immune checkpoint inhibitors (CIs) have revolutionized treatment of advanced melanoma, leading to an emerging population of long-term survivors. Survivors’ quality of life (QOL) and symptom burden are poorly understood. We set out to evaluate symptom burden and QOL in patients with advanced melanoma alive more than 1 year after initiating CI therapy.Methods Cross-sectional surveys, accompanied by chart review of patients with advanced melanoma treated with CIs at Memorial Sloan Kettering Cancer Center, completed therapy, and were alive >1 year after treatment initiation. Surveys were administered between February and August 2018. Surveys included: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, EuroQOL, items from Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events and Fatigue Severity Scale.Results We included 90 patients. The most common CI regimens were ipilimumab plus nivolumab (53%) and pembrolizumab (41%); most patients (71%) were not treated in clinical trials. Median time from CI therapy initiation was 40 months and from last dose was 28 months. Fatigue was reported by 28%, with higher fatigue scores in women than men; 12% reported difficulty sleeping. Aching joints (17%) and muscles (12%) were fairly common. Level of functioning was generally high. Overall QOL was excellent though 40% reported ‘some or moderate’ problems with anxiety/depression and 31% with pain/discomfort.Conclusions After CI therapy, long-surviving advanced melanoma patients commonly report fatigue but otherwise have moderate symptom burden and good QOL. Ensuring appropriate symptom management will optimize clinical outcomes for these patients.https://jitc.bmj.com/content/8/1/e000260.full |
| spellingShingle | Michael A Postow Maha Mamoor Jessica A Lavery Shrujal S Baxi Niloufer Khan Jun J Mao Lauren J Rogak Robert Sidlow Bridgette Thom Jedd A Wolchok Deborah Korenstein Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors Journal for ImmunoTherapy of Cancer |
| title | Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors |
| title_full | Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors |
| title_fullStr | Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors |
| title_full_unstemmed | Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors |
| title_short | Quality of life in long-term survivors of advanced melanoma treated with checkpoint inhibitors |
| title_sort | quality of life in long term survivors of advanced melanoma treated with checkpoint inhibitors |
| url | https://jitc.bmj.com/content/8/1/e000260.full |
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