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Poster Display session

50P - Patient-reported outcomes in non-small cell lung cancer patients receiving immunotherapy monotherapy: Analysis from enhanced, EHR-facilitated cancer symptom control (E2C2) pragmatic clinical trial


31 Mar 2023


Poster Display session


Bolun Liu


Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.


B. Liu1, V. Lam2, D. Pachman2, K. Ruddy2, O. Burke2, P. Lingamaneni2, Y. Yu2, G. Jiang2, A. Cheville2, K. Leventakos3

Author affiliations

  • 1 Mankato/US
  • 2 Mayo Clinic, Rochester/US
  • 3 Mayo Clinic, 55905 - Rochester/US


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Abstract 50P


Immunotherapy has improved or maintained health-related quality of life (QOL) according to patient-reported outcomes (PROs) of non-small cell lung cancer (NSCLC) clinical trials. However, real-world evidence has been limited. Our study describes clinical outcomes and PROs in NSCLC while receiving immunotherapy monotherapy as first-line treatment using real-world data.


We retrospectively collected clinical data and PROs of adult patients with NSCLC who enrolled in Enhanced, EHR-facilitated Cancer Symptom Control (E2C2) pragmatic trial from 3/2019 to 11/2022. PROs were collected by survey in six domains including sleep disturbance, pain, anxiety, physical dysfunction, fatigue, and distress.


Out of 31225 patients with cancer enrolled in E2C2 trial, one-hundred patients were identified to have received immunotherapy monotherapy as first-line treatment for NSCLC. Eighty-three patients had metastatic disease at initiation of immunotherapy; nine had stage III disease, and eight had recurrent disease. Ninety patients received pembrolizumab. Median length of therapy was 15 months. Sixty patients discontinued treatment by censor date; nineteen patients were on active treatment, and eighteen patients were on treatment holiday and active surveillance. Top reasons for discontinuation of therapy were progression (33.3%), immunotherapy-related adverse event (26.7%), and poor performance status (20%). A total of 999 PRO surveys were analyzed. The most frequent moderate to severe symptoms include physical dysfunction (76%), fatigue (75%), and sleeping disturbance (68%); pain (58%), anxiety (55%), and distress (49%) were less frequently reported. For a subgroup of patients (n = 50) whose baseline symptom measurement was available, there was a trend of moderate to severe symptoms decreasing over time.


Our study demonstrated that patients with NSCLC on immunotherapy monotherapy have significant symptom burden, particularly physical dysfunction, fatigue, and sleeping. Our study highlights the unmet supportive care needs of individuals living with NSCLC receiving immunotherapy.

Legal entity responsible for the study

The authors.


Has not received any funding.


K. Leventakos: Non-Financial Interests, Personal, Invited Speaker: OncLive State of the Summit, MJH Life Sciences; Non-Financial Interests, Institutional, Advisory Role: Boehringer Ingelheim Pharmaceuticals, Amgen; Non-Financial Interests, Institutional, Advisory Board: AstraZeneca, Targeted Oncology, Takeda, Jazz Pharmaceuticals, Mirati Therapeutics, Janssen, Regeneron; Non-Financial Interests, Institutional, Advisory Role, Research Support: AstraZeneca; Non-Financial Interests, Institutional, Advisory Role, Research support: Mirati Therapeutics – to institution. All other authors have declared no conflicts of interest.

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