2192P - Quality of life (QoL) of patients (pts) with advanced malignant pleural mesothelioma (aMPM) treated in a real-world setting

Background

Real world QoL data and association with overall survival (OS) for pts with advanced mesothelioma is scarce. Moreover, the associations between health utility scores (HUS) generated from EQ-5D and symptoms as measured by ESAS and pro-CTCAE remain unknown in aMPM pts.

Methods

Through retrospective chart review, clinico-demographic variables and treatment information were captured in pts diagnosed with aMPM between Jan 1, 2004, to Feb 1, 2021 at Princess Margaret Cancer Centre. QoL outcomes were measured using HUS by EQ-5D, ESAS, and pro-CTCAE scales. Changes in QoL were examined by disease state. Survival was examined by baseline QoL using the KM method. Correlation between QoL scales was examined using Spearman’s r.

Results

Of 172 pts with baseline QoL data, median age was 69.6 yrs; 73% were males; 52% were ever smokers; 57% had epithelioid aMPM; 82% received systemic therapy for advanced disease. Based on a mixed effects regression model, ESAS pooled physical and pooled psychological were worst at baseline, improved at stable /responding disease (physical, p=0.001; psychological, p=0.001) and worsened at progressive disease (physical, p=0.003; psychological, p=0.02). Similar trends were seen in HUS (stable to progressive disease p=0.03), and pro-CTCAE symptom severity (baseline to stable disease p=0.03) and frequency (baseline to stable disease p=0.008). Pts with high baseline ESAS physical burden had inferior OS: median 12.1 (high) vs 8.2 months (low) p=0.023, with no impact of psychological burden on OS. Weak to moderate correlations were observed between ESAS domains and HU as well as pro-CTCAE domains and HU. Strongest domain correlations were well-being (ESAS r=-0.39), tiredness/ fatigue (ESAS r=-0.39, severity r=-0.38, interference r=-0.44), and shortness of breath (severity r=-0.35, interference r=-0.44), each p<0.05.

Conclusions

Both HUS and ESAS captured disease state well. Individual ESAS and pro-CTCAE domains showed moderate correlations with HUS, thus validating such scores for future integration into routine clinical care. Physical symptom burden as captured by ESAS impacted OS and could be used as a prognostic tool, if validated in prospective studies.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

A. Sacher: Financial Interests, Institutional, Coordinating PI: Genentech-Roche, BMS, AstraZeneca; Financial Interests, Institutional, Local PI: Amgen, Iovance, CRISPR Therapeutics, Merck, Pfizer, GSK, Spectrum, Lilly. N. Leighl: Financial Interests, Personal, Other, CME/independent lectures: MSD, BMS, F. Hoffmann-La Roche, EMD Serono; Financial Interests, Personal, Invited Speaker, independent lectures: Novartis, Takeda; Financial Interests, Personal, Advisory Board: Puma Biotechnology; Financial Interests, Institutional, Research Grant: Amgen, AstraZeneca, Array, Bayer, EMD Serono, Guardant Health, Lilly, MSD, Pfizer, Roche, Takeda, Janssen. All other authors have declared no conflicts of interest.