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...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e098062.full |
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| 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 |
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