Alwhaibi Abdulrahman, Alenazi Miteb A, Alnofaie Saad D, Aldekhail Abdullah M, Alanazi Rakan J, Alghadeer Sultan, Alghamdi Abdulrhman A, Alanazi Saleh A
Department of Clinical Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
Department of Pediatrics, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.
J Clin Med. 2024 Aug 20;13(16):4918. doi: 10.3390/jcm13164918.
Immune checkpoint inhibitors (ICIs) offer a new treatment approach for cancer, with an improvement in patient survival. However, it remains unclear whether their use impacts the quality of life of treated patients. This study aims to compare the health-related quality of life (HRQoL) of patients treated with different anti-PD-1 and anti-PD-L1 drugs, including several single or combination therapies. This is a prospective observational study conducted with adult cancer patients who received at least one dose of anti-PD-1 or anti-PD-L1. The HRQoL of all adult patients was assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 module (QLQ-C30), version 3, Arabic version. A total of 199 patients were found to be eligible for this study. Of these, 93 patients (82 on a single medication and 11 on multiple ICIs) completed the questionnaire, with a response rate of 46.7%. The majority of patients were treated with pembrolizumab (39.8%), followed by a smaller number treated with nivolumab (35.5%). Most of the patients were diagnosed with solid and advanced malignancies-88.2% ( = 0.023) and 87.1% ( = 0.021), respectively-with a significant difference between treatment groups. The median functioning score was 84.7%, with no significant difference between treatment groups ( = 0.752). Fatigue and pain were noted in >50% of patients, influencing the overall cohort's score related to these symptoms, with scores of 88.8% and 83.3%, respectively. Although a non-significant variation was found in the scores of all combined symptoms among all groups, ranging from 82.1% to 90.4% ( = 0.931), patients receiving anti-PD-1 + anti-PD-L1 tended to more frequently complain about fatigue, pain, dyspnea, and constipation and hence, exhibited the worst, yet non-significant, scores compared to those of the other groups, with = 0.234, = 0.79, = 0.704, and = 0.86, respectively. All combined groups scored 83.3% on the global health scale. Nevertheless, the nivolumab-treated patients scored 75%, which was the worst global health score compared with those of the other groups, but this score was not statistically significant ( = 0.809). Our findings revealed no significant difference in the impact of different ICIs on the HRQoL of cancer patients. However, a larger number of cases would be necessary to provide a robust analysis and to yield conclusive results.
免疫检查点抑制剂(ICIs)为癌症提供了一种新的治疗方法,可提高患者生存率。然而,其使用是否会影响接受治疗患者的生活质量仍不清楚。本研究旨在比较接受不同抗PD-1和抗PD-L1药物治疗的患者的健康相关生活质量(HRQoL),包括几种单一疗法或联合疗法。这是一项针对接受至少一剂抗PD-1或抗PD-L1治疗的成年癌症患者进行的前瞻性观察性研究。所有成年患者的HRQoL使用欧洲癌症研究与治疗组织(EORTC)生活质量问卷核心30模块(QLQ-C30)第3版阿拉伯语版本进行评估。共有199名患者被认为符合本研究的条件。其中,93名患者(82名单一药物治疗和11名多种ICIs治疗)完成了问卷,回复率为46.7%。大多数患者接受派姆单抗治疗(39.8%),其次是接受纳武单抗治疗的患者数量较少(35.5%)。大多数患者被诊断为实体和晚期恶性肿瘤,分别为88.2%(=0.023)和87.1%(=0.021),治疗组之间存在显著差异。中位功能评分为84.7%,治疗组之间无显著差异(=0.752)。超过50%的患者出现疲劳和疼痛,影响了整个队列与这些症状相关的评分,分别为88.8%和83.3%。尽管在所有组中所有综合症状的评分中发现了无显著差异,范围从82.1%到90.4%(=0.931),但接受抗PD-1+抗PD-L1治疗的患者往往更频繁地抱怨疲劳、疼痛、呼吸困难和便秘,因此,与其他组相比,表现出最差但无显著差异的评分,分别为=0.234、=0.79、=0.704和=0.86。所有联合组在总体健康量表上的评分为83.3%。然而,纳武单抗治疗的患者评分为75%,这是与其他组相比最差的总体健康评分,但该评分无统计学意义(=0.809)。我们的研究结果显示,不同ICIs对癌症患者HRQoL的影响无显著差异。然而,需要更多的病例来提供有力的分析并得出确凿的结果。