Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study

Background The introduction of immune checkpoint inhibitors (ICIs) has modified treatment modalities for patients with lung cancer, offering new alternatives for treatment. Despite improved survival benefits, ICIs may cause side effects impacting patients’ quality of life (QoL). We aim to study the...

Full description

Saved in:
Bibliographic Details
Main Authors: Manuela Quaresma, Bernard Rachet, Geertruida H De Bock, Clémence Leyrat, Willemijn J Maas, Erick Suazo-Zepeda, Ananya Malhotra, Petra C Vinke, Jeroen T J.N Hiltermann
Format: Article
Language:English
Published: BMJ Publishing Group 2025-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/2/e098062.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850024241457528832
author Manuela Quaresma
Bernard Rachet
Geertruida H De Bock
Clémence Leyrat
Willemijn J Maas
Erick Suazo-Zepeda
Ananya Malhotra
Petra C Vinke
Jeroen T J.N Hiltermann
author_facet Manuela Quaresma
Bernard Rachet
Geertruida H De Bock
Clémence Leyrat
Willemijn J Maas
Erick Suazo-Zepeda
Ananya Malhotra
Petra C Vinke
Jeroen T J.N Hiltermann
author_sort Manuela Quaresma
collection DOAJ
description Background The introduction of immune checkpoint inhibitors (ICIs) has modified treatment modalities for patients with lung cancer, offering new alternatives for treatment. Despite improved survival benefits, ICIs may cause side effects impacting patients’ quality of life (QoL). We aim to study the changes in global QoL (gQoL) of patients with advanced-stage lung cancer up to 18 months after treatment with ICIs between 2015 and 2021.Methods and analysis A longitudinal cohort study was conducted using the Oncological Life Study: Living well as a cancer survivor data-biobank from the University Medical Center Groningen. Participants completed the European Organisation for Research and Treatment of Cancer QoL 30-item questionnaire, at the beginning of their ICI treatment (baseline) and then at 6, 12 and 18 months. Using joint modelling, changes in predicted mean gQoL were studied by treatment regimens from baseline to 18 months, while accounting for the competing risk of death and adjusting for prespecified covariates.Results Of the 418 participants with median age of 66 years, 39% were women. Patients receiving first-line immuno-monotherapy with palliative intent had a small improvement in their gQoL within 6 months and no clinically significant change thereafter. Patients receiving first-line immune-chemotherapy with palliative intent had a small improvement in their gQoL within 12 months and no clinically significant change thereafter. Patients with second/further line immunotherapy with palliative intent or first-line chemoradiotherapy followed by durvalumab with curative intent had no clinically significant change in their gQoL over 18 months.Conclusion The changes in gQoL over time among patients with advanced-stage lung cancer may vary by treatment regimens based on drug intensity, line and intent of treatment, which will help clinicians and patients understand the potential dynamic of treatments on QoL. It may further influence treatment decisions and patient management strategies, reflecting the practical implications of different treatment regimens.
format Article
id doaj-art-f4f7dc5a4489422c8306e50bb7b08dbd
institution DOAJ
issn 2044-6055
language English
publishDate 2025-02-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-f4f7dc5a4489422c8306e50bb7b08dbd2025-08-20T03:01:10ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-098062Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort studyManuela Quaresma0Bernard Rachet1Geertruida H De Bock2Clémence Leyrat3Willemijn J Maas4Erick Suazo-Zepeda5Ananya Malhotra6Petra C Vinke7Jeroen T J.N Hiltermann81 Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, UK7 Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK4 University Medical Centre Groningen, Groningen, The Netherlands8 Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK5 Department of Neurology, Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands2 Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands1 Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, UK3 Department of Epidemiology, University of Groningen, Groningen, The Netherlands6 Department of Pulmonology, University Medical Centre Groningen, Groningen, The NetherlandsBackground The introduction of immune checkpoint inhibitors (ICIs) has modified treatment modalities for patients with lung cancer, offering new alternatives for treatment. Despite improved survival benefits, ICIs may cause side effects impacting patients’ quality of life (QoL). We aim to study the changes in global QoL (gQoL) of patients with advanced-stage lung cancer up to 18 months after treatment with ICIs between 2015 and 2021.Methods and analysis A longitudinal cohort study was conducted using the Oncological Life Study: Living well as a cancer survivor data-biobank from the University Medical Center Groningen. Participants completed the European Organisation for Research and Treatment of Cancer QoL 30-item questionnaire, at the beginning of their ICI treatment (baseline) and then at 6, 12 and 18 months. Using joint modelling, changes in predicted mean gQoL were studied by treatment regimens from baseline to 18 months, while accounting for the competing risk of death and adjusting for prespecified covariates.Results Of the 418 participants with median age of 66 years, 39% were women. Patients receiving first-line immuno-monotherapy with palliative intent had a small improvement in their gQoL within 6 months and no clinically significant change thereafter. Patients receiving first-line immune-chemotherapy with palliative intent had a small improvement in their gQoL within 12 months and no clinically significant change thereafter. Patients with second/further line immunotherapy with palliative intent or first-line chemoradiotherapy followed by durvalumab with curative intent had no clinically significant change in their gQoL over 18 months.Conclusion The changes in gQoL over time among patients with advanced-stage lung cancer may vary by treatment regimens based on drug intensity, line and intent of treatment, which will help clinicians and patients understand the potential dynamic of treatments on QoL. It may further influence treatment decisions and patient management strategies, reflecting the practical implications of different treatment regimens.https://bmjopen.bmj.com/content/15/2/e098062.full
spellingShingle Manuela Quaresma
Bernard Rachet
Geertruida H De Bock
Clémence Leyrat
Willemijn J Maas
Erick Suazo-Zepeda
Ananya Malhotra
Petra C Vinke
Jeroen T J.N Hiltermann
Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
BMJ Open
title Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
title_full Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
title_fullStr Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
title_full_unstemmed Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
title_short Changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the Netherlands: a 2015–2021 cohort study
title_sort changes in global quality of life after treatment with immune checkpoint inhibitors in patients receiving different treatment regimens for advanced stage lung cancer in the netherlands a 2015 2021 cohort study
url https://bmjopen.bmj.com/content/15/2/e098062.full
work_keys_str_mv AT manuelaquaresma changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT bernardrachet changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT geertruidahdebock changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT clemenceleyrat changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT willemijnjmaas changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT ericksuazozepeda changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT ananyamalhotra changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT petracvinke changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy
AT jeroentjnhiltermann changesinglobalqualityoflifeaftertreatmentwithimmunecheckpointinhibitorsinpatientsreceivingdifferenttreatmentregimensforadvancedstagelungcancerinthenetherlandsa20152021cohortstudy