Abstract 191P
Background
Concurrent chemoradiotherapy (CRT) followed by durvalumab maintenance therapy (D) is the standard treatment for inoperable stage III NSCLC. While clinician-reported outcomes (CROs) standardize treatment assessments, they may not fully reflect patient experiences. This study explored the relationship between patient-reported outcomes (PROs) and CROs during CRT and D.
Methods
Data from 40 inoperable stage III NSCLC patients undergoing CRT+D were collected prospectively at six predefined time points: before (baseline), during, and after CRT, as well as 3, 6, and 12 months afterward. Patient-reported outcomes (PROs) were assessed using the EORTC QLQ-C30 and QLQ-LC13 questionnaires, while clinical-reported outcomes (CROs) were measured via CTCAE v5.0.
Results
PRO compliance exceeded 95% (n=229 questionnaires). The baseline mean symptom scores were as follows: cough 40.8 (SD 31.6), dyspnea 26.9 (28.2), chest pain 17.5 (25.4), fatigue 44.7 (27.8), and appetite loss 30 (36.8). The mean physical function and global health status scores were 70 (SD 26.2) and 53.3 (20.4). Estimated mean changes (points) from baseline to 6 and 12 months using a mixed model for repeated measures (MMRM) were: cough 3.0 (95%CI: −5.9 to 11.9) and 9.0 (−0.4 to 18.5); dyspnea 8.1 (2.4 to 13.9) and 5.9 (−1.9 to 11.9); chest pain −1.1 (−8.8 to 6.6) and 3.6 (−4.7 to 11.9); global health 1.9 (−3.6 to 7.4) and 3.1 (−2.8 to 8.9). Cronbach’s alpha indicated poor consistency between the corresponding QLQ-C30, QLQ-LC13, and CTCAE items: dyspnea (QLQ-C30) vs. CTCAE 0.57; dysphagia (QLQ-LC13) vs. CTCAE 0.56; dyspnea (QLQ-LC13) vs. CTCAE 0.52; and coughing (QLQ-LC13) vs. CTCAE 0.49.
Conclusions
Symptom scores remained low throughout therapy, consistent with the PACIFIC trial results, which showed no deterioration in PROs. The discrepancies between PROs and CROs emphasize their complementary nature, as PROs capture subjective experiences and CROs focus on clinical parameters. These gaps underline the need for enhanced communication, better measurement tools, and increased attention to patient needs, reinforcing the significance of PROs in patient-centered care. Clinical trial identification: NCT05027165.
Editorial acknowledgement
L. Käsmann, K. Khaltar, F. Manapov and C. Eze contributed equally to the submitted work.
Legal entity responsible for the study
The authors.
Funding
AstraZeneca.
Disclosure
L. Käsmann: Financial Interests, Personal and Institutional, Research Grant: AstraZeneca. All other authors have declared no conflicts of interest.