555P - Quality of life in patients with stage IV non-small cell lung cancer and the influence of druggable mutations over time: A prospective, territory-wide study in Hong Kong

Background

Approximately half of non-small cell lung cancer (NSCLC) patients are diagnosed at a metastatic stage. Molecular testing is vital for identifying druggable mutations in these patients. This prospective study aimed to assess the quality of life (QoL) of these patients and differences in QoL between patients with or without druggable mutations.

Methods

Patients newly diagnosed with stage IV NSCLC after March 2021 from the seven public oncology centres in Hong Kong were eligible. Mutation profiling was performed using next-generation sequencing with FoundationOne CDx. QoL assessments were conducted at baseline and then at 3, 6, 9, and 12 months using validated EORTC QLQ-C30 and EQ-5D-5L questionnaires.

Results

A total of 580 patients were included. Statistically significant changes in various aspects of QoL were observed over time, including global health status (QL), physical functioning (PF), role functioning (RF), emotional functioning (EF), social functioning (SF), as well as symptoms such as fatigue, pain, dyspnoea, and insomnia (all p < 0.05). There was also significant change in all 5 aspects of EQ-5D-5L and utility score over time. Overall, most improvements in functional and symptom scales were observed in the first 3-6 months’ follow-up. Among the 241 patients with at least 3 months’ follow-up, compared to those without druggable mutations, those with druggable mutations demonstrated better QL at 3- and 12-month (mean difference (MD) 6.11, p=0.04; MD 19.56, p=0.01, respectively), PF at 3-, 6-, and 12-month (MD 12.76, p=0.001; MD 14.62, p=0.01; MD 22.55, p=0.02), EF at 12-month (MD 21.76, p = 0.001), and SF at 6- and 12-month (MD 14.51, p=0.02; MD 21.86, p=0.04); improved pain at 6- and 12-month (MD 14.44, p = 0.03; MD 36.57, p = 0.02), dyspnoea at 3-month (MD 18.23, p<0.001) and appetite at 6-month (MD 15.23, p = 0.04). They also had higher utility scores at 3- and 6-month intervals (MD 0.13, p = 0.04; MD 0.23, p = 0.05).

Conclusions

In conclusion, this study demonstrated improvements in QoL and symptom relief in newly diagnosed stage IV NSCLC patients within the first 3-6 months in Hong Kong. Patients with druggable mutations generally experienced better QoL compared to those without.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The University of Hong Kong.

Funding

Roche.

Disclosure

All authors have declared no conflicts of interest.