Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug 12:9:715.
doi: 10.3389/fonc.2019.00715. eCollection 2019.

Health-Related Quality of Life in Advanced Non-small Cell Lung Cancer: A Methodological Appraisal Based on a Systematic Literature Review

Lotte Van Der Weijst  1 , Yolande Lievens  1 , Wim Schrauwen  2 , Veerle Surmont  3
Affiliations

Health-Related Quality of Life in Advanced Non-small Cell Lung Cancer: A Methodological Appraisal Based on a Systematic Literature Review

Lotte Van Der Weijst et al. Front Oncol. .

Abstract

Background: The majority of lung cancer patients are diagnosed with advanced non-small cell lung cancer (NSCLC), the bulk of which receive palliative systemic treatment with the goal to provide effective symptom palliation and safeguard health-related quality of life (HRQoL). Advanced NSCLC trials with HRQoL endpoints face methodological constraints limiting interpretability. Objectives: We provide a comprehensive overview of recent clinical trials evaluating the impact of systemic therapies on HRQoL in advanced NSCLC, focusing on the methodological quality, with the ultimate goal to improve interpretation, comparison and reporting of HRQoL data. Methods: A systematic literature review was performed. Prospective studies published over the last decade evaluating the impact of systemic treatments on HRQoL in advanced NSCLC were included. Methodological quality of HRQoL reporting was assessed with the CONSORT-PRO extension. Results: Hundred-twelve manuscripts describing 85 trials met all criteria. No formal conclusion can be drawn regarding the impact on HRQoL of different treatments. We report an important variety in methodological quality in terms of definitions of HRQoL, missing data points, lack of standardization of analyzing and presenting HRQoL and no standard follow-up time. The quality of HRQoL data reporting varies substantially between studies but improves over time. Conclusion: This review shows that in the heterogeneous landscape of trials addressing HRQoL in advanced stage NSCLC. Methodology reporting remains generally poor. Adequate reporting of HRQoL outcome data is equally important to support clinical decision-making as to correctly inform health policy regarding direct approval and reimbursement of the new drugs and combinations that will come online.

Keywords: NSCLC; lung cancer; methodological quality; quality of life; review–systematic.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart describing the selection of eligible manuscripts.
Figure 2
Figure 2
(A) Overview of different therapies incorporated in clinical trials over the last 10 years. *Based on the year of HRQoL publication; CT, chemotherapy vs. chemotherapy or placebo; TT, targeted therapy vs. targeted therapy or placebo; CT vs. TT, chemotherapy vs. targeted therapy; sequential: sequential therapy consisting of both targeted and chemotherapy; CT vs. IM, chemotherapy vs. immunotherapy. (B) Overview of clinical trials with/without significant differences in HRQoL between therapy arms over the last 10 years. *Based on the year of HRQoL publication; MCID, meaningful clinically important difference.
Table 2
Table 2
Summary of quality of HRQoL reporting.
Figure 3
Figure 3
Overview of the quality aspects of PROs of each individual studies.
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2018) 68:394–424. 10.3322/caac.21492 - DOI - PubMed
    1. Reck M, Heigener DF, Mok T, Soria JC, Rabe KF. Management of non-small-cell lung cancer: Recent developments. Lancet. (2013) 382:709–19. 10.1016/S0140-6736(13)61502-0 - DOI - PubMed
    1. Damm K, Roeske N, Jacob C. Health-related quality of life questionnaires in lung cancer trials: a systematic literature review. Health Econ Rev. (2013) 3:15. 10.1186/2191-1991-3-15 - DOI - PMC - PubMed
    1. Goodwin PJ, Black JT, Bordeleau LJ, Ganz PA. Health-related quality-of-life measurement in randomized clinical trials in breast cancer–taking stock. J Natl Cancer Inst. (2003) 95:263–81. 10.1093/jnci/95.4.263 - DOI - PubMed
    1. Osoba D. Health-related quality of life and cancer clinical trials. Ther Adv Med Oncol. (2011) 3:57–71. 10.1177/1758834010395342 - DOI - PMC - PubMed

Publication types