Health-related quality of life of long-term advanced melanoma survivors treated with anti-CTLA-4 immune checkpoint inhibition compared to matched controls
Boekhout, A H; Rogiers, A; Jozwiak, K; Boers-Sonderen, M J; van den Eertwegh, A J; Hospers, G A; de Groot, J W B; Aarts, M J B; Kapiteijn, E; Ten Tije, A J; Piersma, D; Vreugdenhil, G; van der Veldt, A A; Suijkerbuijk, K P M; Rozeman, E A; Neyns, B; Janssen, K J; van de Poll-Franse, L V; Blank, C U
(2021) Acta Oncologica, volume 60, issue 1, pp. 69 - 77
(Article)
Abstract
Background: Checkpoint inhibitors have changed overall survival for patients with advanced melanoma. However, there is a lack of data on health-related quality of life (HRQoL) of long-term advanced melanoma survivors, years after treatment. Therefore, we evaluated HRQoL in long-term advanced melanoma survivors and compared the study outcomes with matched controls
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without cancer. Material and methods: Ipilimumab-treated advanced melanoma survivors without evidence of disease and without subsequent systemic therapy for a minimum of two years following last administration of ipilimumab were eligible for this study. The European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC QLQ-C30), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Melanoma questionnaire (FACT-M) were administered. Controls were individually matched for age, gender, and educational status. Outcomes of survivors and controls were compared using generalized estimating equations, and differences were interpreted as clinically relevant according to published guidelines. Results: A total of 89 survivors and 265 controls were analyzed in this study. After a median follow-up of 39 (range, 17–121) months, survivors scored significantly lower on physical (83.7 vs. 89.8, difference (diff) = −5.80, p=.005), role (83.5 vs. 90, diff = −5.97, p=.02), cognitive (83.7 vs. 91.9, diff = −8.05, p=.001), and social functioning (86.5 vs. 95.1, diff = −8.49, p= <.001) and had a higher symptom burden of fatigue (23.0 vs. 15.5, diff = 7.48, p=.004), dyspnea (13.3 vs. 6.7, diff = 6.47 p=.02), diarrhea (7.9 vs. 4.0, diff = 3.78, p=.04), and financial impact (10.5 vs. 2.5, diff = 8.07, p=.001) than matched controls. Group differences were indicated as clinically relevant. Discussion: Compared to matched controls, long-term advanced melanoma survivors had overall worse functioning scores, more physical symptoms, and financial difficulties. These data may contribute to the development of appropriate survivorship care.
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Keywords: health-related quality of life, immune checkpoint inhibition, matched controls, Melanoma, survivors, Hematology, Oncology, Radiology Nuclear Medicine and imaging, Journal Article
ISSN: 0284-186X
Publisher: Informa Healthcare
Note: Funding Information: A.H. Boekhout received a research grant from Bristol-Myers Squibb for this study. A. Rogiers: Bristol-Myers Squibb and Merck Sharp & Dome (consulting and advisory board). M. Boers-Sonderen: Bristol-Myers Squibb, Pierre Fabre, and Roch (advisory board). A.J.M. van den Eertwegh: Sanofi, Bristol-Myers Squibb and Roche (study grant); MSD Oncology, Roche, Pfizer, and Sanofi (travel expenses); Bristol-Myers Squibb (honoraria); Bristol-Myers Squibb, MSD Oncology, Amgen, Roche, Novartis, Sanofi, Pfizer, Ipsen, and Merck (advisory board). G.A. Hospers: Bristol-Myers Squibb, Amgen, Roche, Pfizer, Novartis, MSD (consulting and advisory board) and received research grants from Bristol-Myers Squibb and Seerave. J.W.B. de Groot: Bristol-Myers Squibb, MSD Oncology, Novartis, Pierre Fabre and Servier (consulting and advisory board). M.J.B. Aarts: Bristol-Myers Squibb, Merck Sharp & Dome, Pfizer, Pierre Fabre, Astellas, Ipsen and Novartis (consulting). K.P.M. Suijkerbuijk reports personal fees as a consult advisor (paid to institution) advisory role: Roche, Novartis, MSD, BMS, Pierre Fabre (all paid to institution). H.W. Kapiteijn: Amgen, Bristol-Myers Squibb, Novartis, Roche, Merck, Pierre-Fabre, EISAI, Bayer and Genzyme-Sanofi (consulting and advisory board); and received a research grant from Bristol-Myers Squibb. A.A.M. van der Veldt: Bayer (travel expenses) and Bristol-Myers Squibb, Merck Sharp & Dome, Roche, Novartis, Pierre Fabre, Pfizer, Sanofi, Eisai and Ipsen (consulting and advisory board). E.A. Rozeman: Merck Sharp & Dome and NanoString (travel expenses). K.J. Jansen is working at Bristol-Myers Squibb. B. Neyns: Bristol-Myers Squibb, Merck Sharp & Dome, Novartis, and Roche (honoraria), and Bristol-Myers Squibb, Merck Sharp & Dome, Novartis, Roche, Speakers’ Bureau-Novartis (consulting and advisory), and Amgen, Bristol-Myers Squibb, Merck Sharp & Dome, Novartis, and Roche (travel expenses). C.U. Blank reports personal fees as a consultant advisor (paid to the institution) or travel support. All other authors declare no competing interests (Vreugdenhil, Kasia, Djura, and ten Tije). Publisher Copyright: © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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