Patient-reported outcomes as a prognostic marker of survival in patients with advanced nonsmall cell lung cancer treated with immunotherapy.
Identifieur interne : 000224 ( Main/Exploration ); précédent : 000223; suivant : 000225Patient-reported outcomes as a prognostic marker of survival in patients with advanced nonsmall cell lung cancer treated with immunotherapy.
Auteurs : Ashley M. Hopkins [Australie] ; Jordan Wagner [Australie] ; Ganessan Kichenadasse [Australie] ; Natansh Modi [Australie] ; Andrew Rowland [Australie] ; Michael J. Sorich [Australie]Source :
- International journal of cancer [ 1097-0215 ] ; 2020.
Abstract
There has been minimal research on the prognostic value of patient-reported outcomes (PROs) for immune checkpoint inhibitors (ICIs). The relative performance of PROs compared to established markers such as Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and the Lung Immune Prognostic Index (LIPI) is unknown. In our study, data from the advanced nonsmall cell lung cancer (NSCLC) single-arm atezolizumab trials BIRCH, FIR and randomised-trials OAK, POPLAR (atezolizumab vs docetaxel) were pooled. The study included 1548 participants who initiated atezolizumab. The associations between pretreatment PROs and overall survival (OS) and progression-free survival (PFS) were modelled using Cox proportional hazards regression. Prediction performance was assessed using the C-statistic (c). PROs were recorded via the EORTC QLQ-C30 and QLQ-LC13. Patient-reported physical function, fatigue, global health, appetite, role function, pain, dyspnoea, social function, constipation, nausea-vomiting, emotional function and coughing were significantly associated with OS and PFS on univariable and adjusted analysis (P < .05). Physical function (c = 0.654), fatigue (c = 0.653) and global health (c = 0.650) were the most predictive variables for OS. Comparatively, the OS prediction performance of physical function (c = 0.65) was superior to ECOG-PS (c = .59) and LIPI (c = 0.63). On multivariable analysis physical function, ECOG-PS and LIPI were all significant (P < .001). In conclusion, PROs were identified as independent prognostic factors for OS and PFS in advanced NSCLC patients receiving ICI therapy. Further, patient-reported physical function was more predictive of OS than ECOG-PS and LIPI and contained independent information. This highlights the value of PROs as prognostic and stratification factors for clinical use and research trials of ICIs.
DOI: 10.1002/ijc.33133
PubMed: 32492185
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Hopkins</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Wagner, Jordan" sort="Wagner, Jordan" uniqKey="Wagner J" first="Jordan" last="Wagner">Jordan Wagner</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Kichenadasse, Ganessan" sort="Kichenadasse, Ganessan" uniqKey="Kichenadasse G" first="Ganessan" last="Kichenadasse">Ganessan Kichenadasse</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Modi, Natansh" sort="Modi, Natansh" uniqKey="Modi N" first="Natansh" last="Modi">Natansh Modi</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Rowland, Andrew" sort="Rowland, Andrew" uniqKey="Rowland A" first="Andrew" last="Rowland">Andrew Rowland</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Sorich, Michael J" sort="Sorich, Michael J" uniqKey="Sorich M" first="Michael J" last="Sorich">Michael J. 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Hopkins</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Wagner, Jordan" sort="Wagner, Jordan" uniqKey="Wagner J" first="Jordan" last="Wagner">Jordan Wagner</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Kichenadasse, Ganessan" sort="Kichenadasse, Ganessan" uniqKey="Kichenadasse G" first="Ganessan" last="Kichenadasse">Ganessan Kichenadasse</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Modi, Natansh" sort="Modi, Natansh" uniqKey="Modi N" first="Natansh" last="Modi">Natansh Modi</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Rowland, Andrew" sort="Rowland, Andrew" uniqKey="Rowland A" first="Andrew" last="Rowland">Andrew Rowland</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author><author><name sortKey="Sorich, Michael J" sort="Sorich, Michael J" uniqKey="Sorich M" first="Michael J" last="Sorich">Michael J. Sorich</name><affiliation wicri:level="1"><nlm:affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>College of Medicine and Public Health, Flinders University, Adelaide</wicri:regionArea><wicri:noRegion>Adelaide</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of cancer</title><idno type="eISSN">1097-0215</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">There has been minimal research on the prognostic value of patient-reported outcomes (PROs) for immune checkpoint inhibitors (ICIs). The relative performance of PROs compared to established markers such as Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and the Lung Immune Prognostic Index (LIPI) is unknown. In our study, data from the advanced nonsmall cell lung cancer (NSCLC) single-arm atezolizumab trials BIRCH, FIR and randomised-trials OAK, POPLAR (atezolizumab vs docetaxel) were pooled. The study included 1548 participants who initiated atezolizumab. The associations between pretreatment PROs and overall survival (OS) and progression-free survival (PFS) were modelled using Cox proportional hazards regression. Prediction performance was assessed using the C-statistic (c). PROs were recorded via the EORTC QLQ-C30 and QLQ-LC13. Patient-reported physical function, fatigue, global health, appetite, role function, pain, dyspnoea, social function, constipation, nausea-vomiting, emotional function and coughing were significantly associated with OS and PFS on univariable and adjusted analysis (P < .05). Physical function (c = 0.654), fatigue (c = 0.653) and global health (c = 0.650) were the most predictive variables for OS. Comparatively, the OS prediction performance of physical function (c = 0.65) was superior to ECOG-PS (c = .59) and LIPI (c = 0.63). On multivariable analysis physical function, ECOG-PS and LIPI were all significant (P < .001). In conclusion, PROs were identified as independent prognostic factors for OS and PFS in advanced NSCLC patients receiving ICI therapy. Further, patient-reported physical function was more predictive of OS than ECOG-PS and LIPI and contained independent information. This highlights the value of PROs as prognostic and stratification factors for clinical use and research trials of ICIs.</div></front></TEI><pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">32492185</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1097-0215</ISSN><JournalIssue CitedMedium="Internet"><Volume>147</Volume><Issue>11</Issue><PubDate><Year>2020</Year><Month>Dec</Month><Day>01</Day></PubDate></JournalIssue><Title>International journal of cancer</Title><ISOAbbreviation>Int J Cancer</ISOAbbreviation></Journal><ArticleTitle>Patient-reported outcomes as a prognostic marker of survival in patients with advanced nonsmall cell lung cancer treated with immunotherapy.</ArticleTitle><Pagination><MedlinePgn>3085-3089</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/ijc.33133</ELocationID><Abstract><AbstractText>There has been minimal research on the prognostic value of patient-reported outcomes (PROs) for immune checkpoint inhibitors (ICIs). The relative performance of PROs compared to established markers such as Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and the Lung Immune Prognostic Index (LIPI) is unknown. In our study, data from the advanced nonsmall cell lung cancer (NSCLC) single-arm atezolizumab trials BIRCH, FIR and randomised-trials OAK, POPLAR (atezolizumab vs docetaxel) were pooled. The study included 1548 participants who initiated atezolizumab. The associations between pretreatment PROs and overall survival (OS) and progression-free survival (PFS) were modelled using Cox proportional hazards regression. Prediction performance was assessed using the C-statistic (c). PROs were recorded via the EORTC QLQ-C30 and QLQ-LC13. Patient-reported physical function, fatigue, global health, appetite, role function, pain, dyspnoea, social function, constipation, nausea-vomiting, emotional function and coughing were significantly associated with OS and PFS on univariable and adjusted analysis (P < .05). Physical function (c = 0.654), fatigue (c = 0.653) and global health (c = 0.650) were the most predictive variables for OS. Comparatively, the OS prediction performance of physical function (c = 0.65) was superior to ECOG-PS (c = .59) and LIPI (c = 0.63). On multivariable analysis physical function, ECOG-PS and LIPI were all significant (P < .001). In conclusion, PROs were identified as independent prognostic factors for OS and PFS in advanced NSCLC patients receiving ICI therapy. Further, patient-reported physical function was more predictive of OS than ECOG-PS and LIPI and contained independent information. This highlights the value of PROs as prognostic and stratification factors for clinical use and research trials of ICIs.</AbstractText><CopyrightInformation>© 2020 UICC.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hopkins</LastName><ForeName>Ashley M</ForeName><Initials>AM</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-7652-4378</Identifier><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wagner</LastName><ForeName>Jordan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kichenadasse</LastName><ForeName>Ganessan</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Modi</LastName><ForeName>Natansh</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rowland</LastName><ForeName>Andrew</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sorich</LastName><ForeName>Michael J</ForeName><Initials>MJ</Initials><Identifier Source="ORCID">https://orcid.org/0000-0003-1999-866X</Identifier><AffiliationInfo><Affiliation>College of Medicine and Public Health, Flinders University, Adelaide, Australia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Cancer Council South Australia</Agency><Country></Country></Grant><Grant><Agency>National Breast Cancer Foundation, Australia</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Int J Cancer</MedlineTA><NlmUniqueID>0042124</NlmUniqueID><ISSNLinking>0020-7136</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">advanced nonsmall cell lung cancer</Keyword><Keyword MajorTopicYN="N">immune checkpoint inhibitors</Keyword><Keyword MajorTopicYN="N">patient-reported outcomes</Keyword><Keyword MajorTopicYN="N">prediction</Keyword><Keyword MajorTopicYN="N">survival</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>26</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>6</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>6</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32492185</ArticleId><ArticleId IdType="doi">10.1002/ijc.33133</ArticleId></ArticleIdList><ReferenceList><Title>REFERENCES</Title><Reference><Citation>Hopkins AM, Rowland A, Kichenadasse G, et al. 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Lancet. 2016;387:1837-1846.</Citation></Reference><Reference><Citation>Peters S, Gettinger S, Johnson ML, et al. Phase II trial of atezolizumab as first-line or subsequent therapy for patients with programmed death-ligand 1-selected advanced non-small-cell lung cancer (BIRCH). J Clin Oncol. 2017;35:2781-2789.</Citation></Reference><Reference><Citation>Spigel DR, Chaft JE, Gettinger S, et al. FIR: efficacy, safety, and biomarker analysis of a phase II open-label study of atezolizumab in PD-L1-selected patients with NSCLC. J Thorac Oncol. 2018;13:1733-1742.</Citation></Reference><Reference><Citation>Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365-376.</Citation></Reference><Reference><Citation>Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC Core quality of life questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC study group on quality of life. Eur J Cancer. 1994;30a:635-642.</Citation></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Hopkins, Ashley M" sort="Hopkins, Ashley M" uniqKey="Hopkins A" first="Ashley M" last="Hopkins">Ashley M. Hopkins</name></noRegion><name sortKey="Kichenadasse, Ganessan" sort="Kichenadasse, Ganessan" uniqKey="Kichenadasse G" first="Ganessan" last="Kichenadasse">Ganessan Kichenadasse</name><name sortKey="Kichenadasse, Ganessan" sort="Kichenadasse, Ganessan" uniqKey="Kichenadasse G" first="Ganessan" last="Kichenadasse">Ganessan Kichenadasse</name><name sortKey="Modi, Natansh" sort="Modi, Natansh" uniqKey="Modi N" first="Natansh" last="Modi">Natansh Modi</name><name sortKey="Rowland, Andrew" sort="Rowland, Andrew" uniqKey="Rowland A" first="Andrew" last="Rowland">Andrew Rowland</name><name sortKey="Sorich, Michael J" sort="Sorich, Michael J" uniqKey="Sorich M" first="Michael J" last="Sorich">Michael J. Sorich</name><name sortKey="Wagner, Jordan" sort="Wagner, Jordan" uniqKey="Wagner J" first="Jordan" last="Wagner">Jordan Wagner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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