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. 2025 Jun 5;32(6):332.
doi: 10.3390/curroncol32060332.

Quality of Life of Lung Cancer Patients with Immune-Related Endocrinopathies During Immunotherapy: A Prospective Study Based on the EORTC QLQ-C30 and QLQ-LC13 Questionnaires in Romania

Simona Coniac  1   2 , Mariana Cristina Costache-Outas  3 , Ionuţ-Lucian Antone-Iordache  4 , Alexandra-Valentina Anghel  5 , Maria-Alexandra Bobolocu  5 , Andreea Zamfir  5 , Horia-Dan Liscu  4   5 , Andreea-Iuliana Ionescu  5   6 , Corin Badiu  2   7
Affiliations

Quality of Life of Lung Cancer Patients with Immune-Related Endocrinopathies During Immunotherapy: A Prospective Study Based on the EORTC QLQ-C30 and QLQ-LC13 Questionnaires in Romania

Simona Coniac et al. Curr Oncol. .

Abstract

(1) Background: Globally, lung cancer is the leading cause of cancer death, but immunotherapy has impressively improved the outcomes, generating longer progression-free survival and overall survival. Endocrine immune-related adverse events (irAEs) are mostly irreversible and need life-long hormonal substitution therapy. The evaluation of the quality of life of lung cancer patients experiencing endocrine toxicities during immune checkpoint inhibitor (ICI) treatment is relevant for both patients and healthcare providers. (2) Methods: This was a prospective cohort study of lung cancer patients treated with immune checkpoint inhibitors in a tertiary-level hospital in Romania from 1 December 2021 to 30 September 2024. Quality of life was assessed using versions of the EORTC QLQ-C30 and EORTC QLQ-LC-13 validated and translated into the Romanian language. We investigated several clinical variables to evaluate their impact on QoL. (3) Results: Fifty-nine lung cancer patients were evaluated for their QoL before ICI initiation and at the end of the study. Endocrine-irAEs occurred in 17 lung cancer patients (28.8%). Quality of life as assessed using the EORTC questionnaires was statistically significantly improved, even in patients experiencing endocrine-irAEs. (4) Conclusions: Our prospective cohort study succeeded in delivering the proof of concept of an increased QoL in lung cancer patients who had developed endocrine-irAEs under immunotherapy. Despite toxicities, especially rather frequent endocrine-irAEs, ICIs enabled durable disease control and symptom relief, improving the QoL of the overall trial population. As more lung cancer patients undergo immunotherapy in metastatic or early stages, we draw attention to this particular patient population with autoimmune endocrinopathies, as they will live longer and require life-long hormonal therapy.

Keywords: Romania; endocrine immune-related adverse events; immune checkpoint inhibitors; lung cancer; quality of life questionnaire.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the study cohort.
Figure 2
Figure 2
QLQ-C30 functional scales and summary score at the beginning of ICI treatment versus at the study endpoint.
Figure 3
Figure 3
QLQ-C30 symptom scale at the beginning of ICI treatment versus at the study endpoint.
Figure 4
Figure 4
QLQ-LC13 symptom scales at the beginning of ICI treatment versus at the study endpoint.
Figure 5
Figure 5
A cause–effect diagram illustrating the negative influence of ICI predictors on the QoL scores.
Figure 6
Figure 6
A cause–effect diagram illustrating the positive influence of ICI predictors on the QoL scores.
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