ESMO 2020 — New insights on QoL with ICIs


  • Michael Simm
  • Oncology Conference reports
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Takeaway

  • In one of the first meta-analyses to summarize QoL in patients receiving immune checkpoint inhibitors (ICIs), overall QoL did not change over time.
  • Benefit at follow-up tended to be greater among recipients of nivolumab and pembrolizumab, and among patients with head and neck cancers or renal cell cancers.

Why this matters

  • QoL data from patients receiving ICIs are largely limited to phase 3 trials.
  • This meta-analysis yielded important quantitative information, especially about clinically relevant moderators.

Study design

  • Data for 6965 adult patients with cancer were analyzed, focusing on original data from trials or prospective studies.
  • Comparators were chemotherapy, placebo, other ICIs, or none.
  • Typically, data from week 12 were collected.
  • Funding: National Cancer Institute.

Key results

  • >20,000 potential studies identified, 26 eligible.
  • 9 had low risk for bias (Cochrane assessment), and 17 had high risk.
  • No change of QoL overall (P=.13).
  • However, QoL worsened with ICI (P=.01) and improved with durvalumab (P=.00).
  • QoL also worsened in patients with melanoma, but improved in those with NSCLC, renal cell cancer, and urothelial carcinoma.
    • ICI data stem from melanoma trials, which may explain worse outcomes.
  • QoL at follow-up was better than comparators for nivolumab or pembrolizumab recipients.
  • QoL was also better among patients with head and neck or renal cell cancer.

Limitations

  • Limited data from heterogeneous studies.

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