1249P - Health-related quality of life (HRQoL) at diagnosis for unresectable stage III NSCLC: Results from the French nationwide prospective study OBSTINATE (GFPC 06-2019)

Background

Immunotherapy consolidation (IO) has revolutionized treatment options for patients (pts) with locally advanced NSCLC. However, its effects on health-related quality of life (HRQoL) have not been extensively studied beyond clinical trial settings. The primary aim of the OBSTINATE (GFPC 06-2019) study is to prospectively assess HRQoL in pts with unresectable stage III NSCLC under real-world conditions.

Methods

OBSTINATE is a nationwide prospective multicenter study conducted in France, which enrolled pts between Dec 2020 and Apr 2023. Eligible participants included all pts diagnosed with unresectable stage III NSCLC who were capable of completing HRQoL self-assessment questionnaires (EORTC QLQ-C30, QLQ-LC13, and EQ-5D-5L). HRQoL evaluations were predefined based on the treatment strategy planned for each patient.

Results

413 pts were enrolled in the study from 25 participating centers. Analysis of HRQoL at diagnosis was conducted on pts who had received at least one cycle of chemotherapy (n=368). The majority of the population was male (68.7%), with a history of smoking (94.5%), ECOG PS 0/1 (91.5%), and a median age of 67 years. TNM stage was IIIA, IIIB, and IIIC for 37.7%, 46.6%, and 13.7% of pts, respectively. PD-L1 status was known for 90.5% of pts (<1%: 35.3%; 1-49%: 30.4%; ≥50%: 24.7%). Pts were categorized based on the treatment received: concomitant radio-chemotherapy and IO (cRT/CT-IO) (n=159); sequential (s)RT/CT-IO (n=34); cRT-CT (n=39); sRT-CT (n=36); CT alone (n=54); CT+IO (n=46). Completion of HRQoL questionnaires at baseline was 90.2%. At diagnosis, the global health status and functioning scales of the QLQ-C30 tended to be higher in the cRT/CT-IO group. Symptomatic scales of the QLQ-C30 and QLQ-LC13 tended to favor the cRT/CT-IO group. Consistently, utility scores were numerically higher in the cRT/CT-IO group at diagnosis (mean=0.88±0.17).

Conclusions

OBSTINATE is the first study to prospectively evaluate HRQoL in unresectable stage III NSCLC on a national scale. Pts referred to concomitant cRT-CT-IO treatment tend to have better HRQoL at diagnosis.

Clinical trial identification

NCT05049044.

Editorial acknowledgement

Legal entity responsible for the study

GFPC.

Funding

AstraZeneca.

Disclosure

C. Ricordel: Financial Interests, Personal, Advisory Board: Roche, Takeda, MSD, BMS, Janssen, Sanofi, AstraZeneca. F. Guisier: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, BMS, MSD, Roche, Sanofi, Janssen, Pfizer, Takeda; Financial Interests, Institutional, Research Grant: Pfizer, Roche, Takeda. C. Chouaid: Financial Interests, Personal, Advisory Board: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen; Financial Interests, Institutional, Funding: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen. L. Greillier: Financial Interests, Personal, Advisory Board: AbbVie, AstraZeneca, BMS, MSD, Novartis, Sanofi, Takeda, Roche; Financial Interests, Personal, Invited Speaker: Lilly, Pfizer; Financial Interests, Institutional, Local PI: AstraZeneca, AbbVie, BMS, MSD, Novartis, Takeda, Pfizer, Roche, PharmaMar; Financial Interests, Institutional, Coordinating PI: Sanofi. All other authors have declared no conflicts of interest.