2132P - Unmet needs, quality of life, and financial toxicity in survivors of lung cancer

Background

Survivors of lung cancer (LCS) have unmet emotional, social, and physical needs regardless of stage at diagnosis or treatment types, experience decreased quality of life (QOL) and high financial toxicity (FT). The relationship between unmet needs, QOL, and FT is yet to be reported in LCS and may provide insight into potentially modifiable needs to address to improve patient reported outcomes.

Methods

We performed a cross-sectional survey to assess the physical, social, emotional, and medical needs, QOL, and FT in patients with histologically confirmed non-small cell lung cancer alive > 1 year from diagnosis. The survey consisted of an adapted needs survey, the Comprehensive Score for FT (COST), and the lung cancer specific QOL questionnaires EORTC-QLQ and EORTC-QLQ-LC13. Demographic and clinical information was obtained retrospectively by chart review. Separate multiple linear regression models, treating QOL and FT as dependent variables, were performed to assess the adjusted relationship between total number of unmet needs and type of unmet need (physical, emotional, social or medical) with QOL and FT.

Results

Of 360 LCS approached, 232 surveys were completed. The median age was 69, most were female (62%), married (71%), Caucasian (74%), and had stage III/IV lung cancer (60%). Previous/current smoking history (p=0.042) and ECOG performance status of 1 or ≥ 2 (compared to 0) (p<0.0001) were each independently associated with decreased QOL. Income < $30,000 or $30,000-75,000 (compared to >$75,000) (p<0.0001), and history of radiation therapy (p=0.023) were independently associated with increased FT. Higher total unmet needs was associated with lower QOL (p<0.0001) and increased FT (p=0.0003). Greater unmet physical (p=0.023), social (p=0.008), and medical needs (p=0.007) were associated with decreased QOL. Greater social needs were associated with increased FT (p<0.0001).

Conclusions

Unmet needs across multiple domains are associated with worse QOL and FT in LCS. Identifying specific modifiable unmet needs, such as patient symptoms, care coordination, or tobacco cessation, are needed to help identify interventions. Future studies with targeted inventions to address these unmet needs may improve QOL and FT in LCS.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

J. Feliciano.

Funding

AstraZeneca.

Disclosure

J. Feliciano: Other, Institutional, Research Grant, transitions: Bristol Myers Squibb; Other, Institutional, Research Grant, survivorship: AstraZeneca; Other, Institutional, Research Grant, 4R: Pfizer; Other, Personal, Advisory Role, consultation: Regeneron; Other, Personal, Advisory Board, diversity: Eli Lilly; Other, Personal, Advisory Role: Coherus, Genentech, AstraZeneca, Daiichi; Other, Personal, Expert Testimony: AstraZeneca. M. Turner: Other, Personal, Speaker’s Bureau: AstraZeneca, Merck, Mirati. M.L. Hsu: Other, Personal, Advisory Role: Regeneron. All other authors have declared no conflicts of interest.