Abstract 1687P
Background
Immune checkpoint inhibitors (ICIs) have revolutionized clinical practice in oncology in the last years, leading to a survival benefit in several tumor types. To investigate whether these benefits are associated with improved quality of life, we conducted a systematic review and meta-analysis comparing patient-reported outcomes (PROs) between ICIs and standard chemotherapy (CT) in patients with advanced solid tumors.
Methods
Clinical trials comparing the efficacy of ICIs (either PD-1/PD-L1 inhibitors or CTLA-4 inhibitors, as single agent or in combination) vs. CT were included. Trials evaluating treatment with ICIs plus CT vs. CT alone were also included, whereas studies in which the control arm included other anticancer agents (such as targeted therapy and other ICIs), or placebo were excluded. The aim of our meta-analysis was to compare PROs between subjects treated with ICIs (intervention) and CT (control). The co-primary endpoints were time from baseline to first deterioration (TTD) in PROs, defined as the time from baseline to the first clinically significant deterioration in PROs, and the changes in PROs from baseline to follow-up between ICI and CT treatment groups (PROSPERO registration number CRD42021247440).
Results
A total of 8,341 patients from 17 randomized trials of ICI vs. CT were included in the analysis. Treatment with ICI delayed clinical deterioration over standard CT in Global Health Status/QoL EORTC QLQ-C30 (hazard ratio [HR] 0.81; 95% CI, 0.74-0.89), and in both EQ-5D Utility Index (HR 0.65; 95% CI, 0.52-0.82), and EQ-5D visual analog scale (HR 0.70; 95% CI, 0.61-0.80). The difference in mean change between the ICI-treated group and the CT-treated group in Global Health Status/QoL EORTC QLQ-C30 was 5.82 (95% CI, 4.11-7.53) in favor of ICI. Similarly, in the EQ-5D the mean change differences favored treatment with ICIs in both Utility Index and VAS, with differences of 0.05 (95% CI, 0.03-0.07) and 5.41 (95% CI, 3.39-7.43), respectively.
Conclusions
ICIs are associated with higher levels of quality of life and longer time to clinical deterioration on several PROs scales as compared to CT in different types of solid tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M. Lambertini: Financial Interests, Advisory Board: Roche; Financial Interests, Advisory Board: AstraZeneca; Financial Interests, Advisory Board: Lilly; Financial Interests, Advisory Board: Novartis; Financial Interests, Invited Speaker: Sandoz; Financial Interests, Invited Speaker: Takeda; Financial Interests, Invited Speaker: Pfizer; Financial Interests, Invited Speaker: Lilly; Financial Interests, Invited Speaker: Novartis; Financial Interests, Advisory Board: Roche; Financial Interests, Advisory Board: AstraZeneca; Financial Interests, Advisory Board: Lilly; Financial Interests, Advisory Board: Novartis; Financial Interests, Invited Speaker: Sandoz; Financial Interests, Invited Speaker: Roche; Financial Interests, Invited Speaker: Takeda; Financial Interests, Invited Speaker: Pfizer; Financial Interests, Invited Speaker: Lilly; Financial Interests, Invited Speaker: Novartis. F. Spagnolo: Financial Interests, Advisory Board: Novartis; Financial Interests, Advisory Board: MSD; Financial Interests, Advisory Board: Sun Pharma; Financial Interests, Advisory Board: Pierre Fabre; Financial Interests, Invited Speaker: Roche; Financial Interests, Invited Speaker: Novartis; Financial Interests, Invited Speaker: BMS; Financial Interests, Invited Speaker: MSD; Financial Interests, Invited Speaker: Merck; Financial Interests, Invited Speaker: Sun Pharma; Financial Interests, Invited Speaker: Sanofi; Financial Interests, Invited Speaker: Pierre Fabre. All other authors have declared no conflicts of interest.