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Multicenter Study
. 2025 Dec 10:16:1693295.
doi: 10.3389/fimmu.2025.1693295. eCollection 2025.

Health-related quality of life and psychosocial outcomes in long-term survivors treated with immune checkpoint inhibitors: a nationwide multicenter study

Taha Koray Sahin  1 , Fatih Atalah  2 , Bahadir Koylu  3 , Ahmet Oruc  4 , Aydin Acarbay  2 , Akgun Karakok  2 , Sevgi Dogan  4 , Cevat Ilteris Kikili  3 , Görkem Turhan  5 , Gamze Emin  5 , Selahattin Celik  6 , Ilknur Deliktas Onur  7 , Tuba Ugur Tuzcu  8 , Sedat Biter  9 , Safa Can Efil  10 , Fadime Sinem Ardic  11 , Azer Gokmen  12 , Halil Goksel Guzel  13 , Kadri Turan  14 , Ahmet Kürsad Disli  15 , Salih Tunbekici  16 , Erdem Goker  16 , Mevlude Inanc  15 , Ozlem Ozdemir  14 , Banu Ozturk  13 , Muslih Urun  12 , Hatime Arzu Yasar  11 , Mehmet Ali Nahit Sendur  10 , Ismail Oguz Kara  9 , Osman Sutcuoglu  8 , Ozturk Ates  7 , Tulay Eren  6 , Atila Yildirim  5 , Saadettin Kilickap  17 , Omer Dizdar  1 , Fatma Alev Turker  1 , Mustafa Erman  1 , Mehmet Artac  4 , Fatih Selcukbiricik  3 , Sercan Aksoy  1 , Deniz Can Guven  1
Affiliations
Multicenter Study

Health-related quality of life and psychosocial outcomes in long-term survivors treated with immune checkpoint inhibitors: a nationwide multicenter study

Taha Koray Sahin et al. Front Immunol. .

Abstract

Background: The increasing use of immune checkpoint inhibitors (ICIs) has resulted in a growing population of long-term survivors (LTS). However, the long-term psychosocial and quality of life (QoL) outcomes in these patients remain underexplored. This study aimed to evaluate QoL, psychological morbidity, fear of cancer progression (FoP), and functional outcomes in cancer patients treated with ICIs for at least six months without disease progression.

Methods: This cross-sectional, multicenter study included 346 adult cancer patients from 17 tertiary oncology centers in Türkiye. Participants had received ICIs for ≥6 months in (neo)adjuvant or metastatic settings. Standardized questionnaires assessed QoL, psychological distress, FoP, immune-related adverse events (irAEs), and work status.

Results: The median age of the cohort was 62 years (IQR: 53-69). Average survivor QoL was comparable to the Turkish general population; but 119 (34.5%) survivors had poor QoL. Clinically relevant symptoms of depression and anxiety were present in 24.3% and 20.8% of patients, respectively, while 48% reported FoP. The overall return-to-work rate among patients initially employed was 50.9%, with 72.7% returning within the first year. Depression, anxiety, and FoP were negatively correlated with all QoL domains. All grade irAEs were common (53.8%) but not significantly associated with worse QoL (p=0.149).

Conclusions: This study represents one of the largest cohorts to date evaluating survivorship issues among LTS treated with ICIs. Among patients receiving ICIs for at least six months, nearly one-third experienced impaired QoL, primarily driven by psychological distress and FoP. Further research is needed to address survivorship care in this population.

Keywords: fear of progression; immune checkpoint inhibitors; long-term survivors; quality of life; survivorship care.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
EORTC QLQ-C30 functional subscale score by ICI agent.
Figure 2
Figure 2
EORTC QLQ-C30 functional subscale score by tumor type.
Figure 3
Figure 3
EORTC QLQ-C30 functional subscale score by duration of ICI treatment.
See this image and copyright information in PMC

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