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. 2024 Mar:200:113601.
doi: 10.1016/j.ejca.2024.113601. Epub 2024 Feb 4.

Real-world health-related quality of life outcomes for patients with resected stage III/IV melanoma treated with adjuvant anti-PD1 therapy

Mees Egeler  1 , Julia Lai-Kwon  2 , Renaud Tissier  3 , Itske Fraterman  3 , Anke Kuijpers  4 , Winan Van Houdt  4 , Sofie Wilgenhof  5 , Aparna Rao  6 , Shahneen Sandhu  7 , Rebecca Lee  8 , Hanna Eriksson  9 , Marieke van Leeuwen  3 , Kelly de Ligt  3 , Alexander van Akkooi  10 , Lonneke van de Poll-Franse  3
Affiliations

Real-world health-related quality of life outcomes for patients with resected stage III/IV melanoma treated with adjuvant anti-PD1 therapy

Mees Egeler et al. Eur J Cancer. 2024 Mar.

Abstract

Background: While adjuvant therapy with anti-programmed cell death protein-1 (anti-PD1) for patients with resected stage III/IV melanoma has been shown to improve recurrence-free survival, the overall survival benefit remains uncertain. This study aims to evaluate the impact of adjuvant anti-PD1 therapy on the health-related quality of life (HRQOL) of patients with resected stage III/IV melanoma METHODS: Data was used from two melanoma registries in Australia and the Netherlands. Patients with resected stage III/IV melanoma treated with adjuvant anti-PD1 who completed a baseline and at least one post-baseline HRQOL assessment were included. HRQOL was assessed using the EORTC QLQ-C30 at baseline, 3, 6, and 12 months. Established thresholds were used for interpreting changes in QLQ-C30 scores.

Results: 92 patients were included. Mean symptom and functioning scores improved or remained stable at 12 months compared to baseline. However, a substantial proportion of patients experienced a clinically significant decline in role (39%, μ = -50.8), social (41%, μ = -32.7), or emotional (50%, μ = -25.1) functioning at 12 months compared to baseline. Younger patients were more likely to experience clinically significant deteriorations in role (OR=1.07, 95% CI: 1.02-1.13, p < 0.01) and social (OR=1.06, 95% CI: 1.01-1.11, p = 0.013) functioning.

Conclusion: A significant proportion of patients with resected stage III/IV melanoma who received adjuvant anti-PD1 experienced clinically significant declines in role, social and emotional functioning at 12 months compared to baseline. This highlights the HRQOL issues that may arise during adjuvant anti-PD1 therapy which may require supportive care intervention.

Keywords: Adjuvant anti-PD1 therapy; Health-related quality of life (HRQOL); Resected stage III/IV melanoma.

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Conflict of interest statement

Declaration of Competing Interest The authors disclose the following potential conflicts of interest: WvH: Holds an advisory role, received speakers honorarium, or institutional research grants from Agmen, Novartis, Belpharma, MSD, Sanofi, Sirius Medical. SW: Advisory board member for Eisai, Bristol-Myers Squibb, Pfizer, Novartis, MSD, and Pierre Fabre, with payments made to the institution. SS: Consultant advisor for AstraZeneca, Bristol Myers Squibb, Merck Sharp & Dohme, and Advanced Accelerators Applications (a Novartis company). Grant funding received by the institution from Advanced Accelerators Applications (a Novartis company), Amgen, Merck Sharp & Dohme, Senwha, Genentech, AstraZeneca for investigator-initiated research. RL: Advisory board for Pierre Fabre. Research funding received from BMS, AstraZeneca, and Pierre Fabre. HE: Member of advisory board for Amgen, Pierre Fabre Nordic, BMS, Merck, and Novartis. Research grants received from SkyLine Dx. AvA: Advisory Board / Consultancy Honoraria received from Amgen, Bristol-Myers Squibb, Novartis, MSD-Merck, Merck-Pfizer, Pierre Fabre, Provectus, Sanofi, Sirius Medical, 4SC, Neracare. Research Grants received from Amgen, Merck-Pfizer. All other authors (ME, JLK, IF, AK, AR, MvL KdL LvdP) declare no competing interests.

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