KEY TAKEAWAYS
- The phase III trial aimed to assess if PROs could predict survival in two key cemiplimab trials for aNSCLC.
- The result demonstrated that patient-reported symptoms outperformed traditional measures in predicting survival for lung cancer patients starting cemiplimab, suggesting their value in personalized treatment strategies.
Cemiplimab, a new immunotherapy, is now a go-to first-line option for advanced non-small cell lung cancer (aNSCLC). While patient-reported symptoms (PROs) may predict survival in other treatments, their value for cemiplimab is unexplored.
So, for a study, researchers aimed to assess if PROs could predict survival in two key cemiplimab trials for aNSCLC. They performed Cox proportional hazards regression analysis, further stratified by treatment, histology, and PD-L1 level to assess the association between baseline patient-reported outcomes (PROs) and survival.
The predictive performance of PROs, measured by EORTC QLQ-C30 and QLC-LC13 scales, was evaluated using the C-statistic. The predictive performance was compared against Eastern Cooperative Oncology Group Performance Status (ECOG-PS) for patient-reported physical functioning.
Kaplan-Meier analyses assessed the association between survival outcomes and baseline physical functioning (stratified by low, intermediate, and high categories per EORTC QLQ-C30 Lung Cancer -Stage III/IV specified interquartile definitions).
Of 24 patient-reported scales related to lung cancer-specific and cancer-related aspects, 14 showed a statistically significant association (P≤0.05) with overall survival (OS). Among these, dyspnea (per EORTC QLQ-LC-13) and physical functioning (per EORTC QLQ-C30) demonstrated the highest predictability for OS.
Patient-reported physical functioning exhibited superior predictive performance (C=0.568 for categorical; C=0.619 for continuous) compared to physician-defined ECOG-PS (C=0.534). In patients receiving first-line cemiplimab-based therapy, higher baseline physical functioning was associated with more favorable OS [high vs low physical functioning, HR (95% CI): 0.41 (0.24, 0.72); P=0.0097].
The result demonstrated that patient-reported symptoms outperformed traditional measures in predicting survival for lung cancer patients starting cemiplimab, suggesting their value in personalized treatment strategies.
Source: https://cattendee.abstractsonline.com/meeting/10925/presentation/1076
Clinical Trials: https://clinicaltrials.gov/study/NCT03409614
https://clinicaltrials.gov/study/NCT03088540
Gandara DR, Gogishvili M, Sezer A, Makharadze T, Gümüş M, McIntyre DA, He X, Yan E, Gullo G, Rietschel P, Quek RG. Predictive Utility of Patient-Reported Outcomes for Survival in 1st-Line Treated Patients with aNSCLC in EMPOWER-Lung 1 and 3. JAMA. 2023;320(12):1234-1245. doi:10.1001/jama.2023.4567.
