Liao Kuan, Wong David C, Gomes Fabio, Faivre-Finn Corinne, Moliner Laura, Sperrin Matthew, Yorke Janelle, van der Veer Sabine N
Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
Department of Computer Science, The University of Manchester, Manchester, UK.
BMJ Oncol. 2024 May 15;3(1):e000158. doi: 10.1136/bmjonc-2023-000158. eCollection 2024.
Investigate whether routinely collected electronic patient-reported outcome measures (ePROMs) add prognostic value to clinical and tumour characteristics for adults with advanced non-small cell lung cancer (NSCLC) receiving immunotherapy.
We retrospectively analysed data from adults with advanced NSCLC commencing immunotherapy between April 2019 and June 2022. Prognostic factors were ePROMs on quality of life (EuroQoL five-dimension five-level (EQ-5D-5L); EuroQoL Visual Analogue Scale (EQ-VAS)) and symptoms (patient-reported version of the Common Terminology Criteria for Adverse Events v5.0) completed at baseline and the first follow-up. We performed Cox proportional hazard regression for overall survival and time-to-progression as outcomes, and logistic regression for the onset of severe treatment toxicities (grade ≥3).
We included 379 patients; 161 (42.5%) completed ePROMs at baseline. Median overall survival and time-to-progression were 13.5 months (95% CI 11.3 to 16.7) and 10.5 months (95% CI 8.8 to 13.7), respectively. 36 (9.5%) experienced severe treatment toxicities during follow-up. Patients with lower EQ-5D-5L utility scores (HR per 0.1 unit increase 0.84, 95% CI 0.74 to 0.95) and higher symptom burden (HR 1.11; 95% CI 1.04 to 1.19) had poorer overall survival. This was also true for those with decreased EQ-VAS and increased symptom burden between baseline and the first follow-up. Lastly, only decreased EQ-5D-5L utility scores between baseline and the first follow-up were associated with shorter time-to-progression.
ePROMs may add prognostic value to clinical and tumour characteristics for overall survival in adults with advanced NSCLC receiving immunotherapy.
研究对于接受免疫治疗的晚期非小细胞肺癌（NSCLC）成人患者，常规收集的电子患者报告结局指标（ePROMs）是否能为临床和肿瘤特征增加预后价值。
我们回顾性分析了2019年4月至2022年6月期间开始接受免疫治疗的晚期NSCLC成人患者的数据。预后因素为基线和首次随访时完成的生活质量（欧洲五维度五水平健康量表（EQ-5D-5L）；欧洲五维度视觉模拟量表（EQ-VAS））以及症状（患者报告的不良事件通用术语标准第5.0版）的ePROMs。我们以总生存期和疾病进展时间为结局进行Cox比例风险回归分析，并以严重治疗毒性（≥3级）的发生情况进行逻辑回归分析。
我们纳入了379例患者；161例（42.5%）在基线时完成了ePROMs。中位总生存期和疾病进展时间分别为13.5个月（95%CI 11.3至16.7）和10.5个月（95%CI 8.8至13.7）。36例（9.5%）在随访期间经历了严重治疗毒性。EQ-5D-5L效用得分较低（每增加0.1单位的风险比为0.84，95%CI 0.74至0.95）且症状负担较高（风险比为1.11；95%CI 1.04至1.19）的患者总生存期较差。基线和首次随访之间EQ-VAS降低且症状负担增加的患者也是如此。最后，仅基线和首次随访之间EQ-5D-5L效用得分降低与较短的疾病进展时间相关。
对于接受免疫治疗的晚期NSCLC成人患者，ePROMs可能为临床和肿瘤特征增加总生存期的预后价值。
