1605P - The impact of cancer pain on survival of lung cancer patients receiving immune checkpoint inhibitors

Background

Pain is one of the most common symptoms experienced by cancer patients. Previous studies have shown that unrelieved cancer pain can affect the quality of life dramatically and is associated with worse survival in patients with cancer, including lung cancer. Non-opioid analgesics are often used in the management of cancer pain. Yet whether the usage of non-opioid analgesics can affect the survival of lung cancer patients receiving immune checkpoint inhibitors (ICIs) remains undetermined.

Methods

We identified 910 patients with records of at least two cycles of ICI prescription with or without records of non-opioid analgesics prescription between 2018 and 2020 within the Clinical Data Analysis and Reporting System of Hong Kong. Kaplan-Meier curves and Cox proportional hazards regression analysis were used to compare the overall survival (OS) of patients who received ICI with non-opioid analgesics versus those without.

Results

In total, 765 (84.1%) and 145 (15.9%) patients with lung cancer received ICI with or without non-opioid analgesics, respectively. The median follow-up time was 35.9 months (95% CI: 34.7-37.3 months). Patients with records of non-opioid analgesics prescriptions had significantly shorter OS than those without (13.4 vs 40.5 months, p < 0.0001). In Cox regression analysis, ICI with a history of non-opioid analgesics usage was associated with a significantly worse prognosis. (HR = 2.42, 95% CI: 1.86-3.10, p < 0.001).

Conclusions

Lung cancer patients who received ICI with a history of non-opioid analgesics usage had shorter survival than those without. Patients with a history of non-opioid analgesics usage are likely to have cancer pain or suboptimal tumour control, which were associated with a worse prognosis.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.