Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice

J J Koldenhof; F H van der Baan; E G Verberne; A M Kamphuis; R J Verheijden; E H Tonk; A S van Lindert; J van der Stap; S C Teunissen; P O Witteveen; K P Suijkerbuijk

doi:10.1016/j.jpainsymman.2022.02.013

Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice

J J Koldenhof, F H van der Baan, E G Verberne, A M Kamphuis, R J Verheijden, E H Tonk, A S van Lindert, J van der Stap, S C Teunissen, P O Witteveen, K P Suijkerbuijk

Research output: Contribution to journal › Article › Academic › peer-review

26 Downloads (Pure)

Abstract

CONTEXT: While praised for inducing durable anti-tumour responses, immune checkpoint inhibitors (ICI) also cause immune-related adverse events (irAEs) that can vary in severity and affect health-related quality of life (HRQL).

OBJECTIVES: This study was performed to provide insight into the course of symptoms and the influence of irAEs on HRQL measured with the treatment-specific Utrecht Symptom Diary Immunotherapy (USD-I).

METHODS: In this observational cohort study, melanoma or non-small lung cancer (NSCLC) patients treated with PD(L)1-inhibitors between February 2016 and December 2018 were included. Data on symptoms, wellbeing and influence of side effects on HRQL were obtained using the patient-scored, treatment-specific USD-I, which was completed as part of routine care. Patients scored symptom intensity on a 0-10 numeric rating scale (NRS); NRS≥3 considered clinically relevant.

RESULTS: A total of 162 melanoma (55%) or NSCLC (45%) patients completed 1493 USDs (median seven per patient). Most common patient-reported clinically relevant symptoms were: inactivity, fatigue, pain, cough and sleeping problems. Symptom prevalence decreased during treatment. Patients generally reported a low influence of side effects on HRQL. A higher number of clinically relevant symptoms at a certain time point correlated with poorer wellbeing.

CONCLUSIONS: These data illustrate that ICI-treatment is generally well tolerated. However, especially the number of clinically relevant symptoms can impact patients wellbeing. Systematic use of an ICI-tailored PROM could create a window to discuss symptoms in a structured way which may promote personalized care during treatment.

Original language	English
Pages (from-to)	997-1005
Number of pages	9
Journal	Journal of Pain and Symptom Management
Volume	63
Issue number	6
Early online date	20 Feb 2022
DOIs	https://doi.org/10.1016/j.jpainsymman.2022.02.013
Publication status	Published - Jun 2022

Keywords

Cancer immunotherapy
melanoma
non-small cell lung carcinoma
patient-reported symptoms
supportive care
symptom assessment

Access to Document

10.1016/j.jpainsymman.2022.02.013Licence: CC BY

1-s2.0-S0885392422001026-mainFinal published version, 929 KBLicence: CC BY

Cite this

Koldenhof, J. J., van der Baan, F. H., Verberne, E. G., Kamphuis, A. M., Verheijden, R. J., Tonk, E. H., van Lindert, A. S., van der Stap, J., Teunissen, S. C., Witteveen, P. O., & Suijkerbuijk, K. P. (2022). Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice. Journal of Pain and Symptom Management, 63(6), 997-1005. https://doi.org/10.1016/j.jpainsymman.2022.02.013

@article{050d7dd782ef41958be528fe6a04c444,

title = "Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice",

abstract = "CONTEXT: While praised for inducing durable anti-tumour responses, immune checkpoint inhibitors (ICI) also cause immune-related adverse events (irAEs) that can vary in severity and affect health-related quality of life (HRQL).OBJECTIVES: This study was performed to provide insight into the course of symptoms and the influence of irAEs on HRQL measured with the treatment-specific Utrecht Symptom Diary Immunotherapy (USD-I).METHODS: In this observational cohort study, melanoma or non-small lung cancer (NSCLC) patients treated with PD(L)1-inhibitors between February 2016 and December 2018 were included. Data on symptoms, wellbeing and influence of side effects on HRQL were obtained using the patient-scored, treatment-specific USD-I, which was completed as part of routine care. Patients scored symptom intensity on a 0-10 numeric rating scale (NRS); NRS≥3 considered clinically relevant.RESULTS: A total of 162 melanoma (55%) or NSCLC (45%) patients completed 1493 USDs (median seven per patient). Most common patient-reported clinically relevant symptoms were: inactivity, fatigue, pain, cough and sleeping problems. Symptom prevalence decreased during treatment. Patients generally reported a low influence of side effects on HRQL. A higher number of clinically relevant symptoms at a certain time point correlated with poorer wellbeing.CONCLUSIONS: These data illustrate that ICI-treatment is generally well tolerated. However, especially the number of clinically relevant symptoms can impact patients wellbeing. Systematic use of an ICI-tailored PROM could create a window to discuss symptoms in a structured way which may promote personalized care during treatment.",

keywords = "Cancer immunotherapy, melanoma, non-small cell lung carcinoma, patient-reported symptoms, supportive care, symptom assessment",

author = "Koldenhof, {J J} and {van der Baan}, {F H} and Verberne, {E G} and Kamphuis, {A M} and Verheijden, {R J} and Tonk, {E H} and {van Lindert}, {A S} and {van der Stap}, J and Teunissen, {S C} and Witteveen, {P O} and Suijkerbuijk, {K P}",

note = "Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = jun,

doi = "10.1016/j.jpainsymman.2022.02.013",

language = "English",

volume = "63",

pages = "997--1005",

journal = "Journal of Pain and Symptom Management",

issn = "0885-3924",

publisher = "Elsevier",

number = "6",

}

Koldenhof, JJ, van der Baan, FH, Verberne, EG, Kamphuis, AM, Verheijden, RJ, Tonk, EH, van Lindert, AS, van der Stap, J, Teunissen, SC , Witteveen, PO & Suijkerbuijk, KP 2022, 'Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice', Journal of Pain and Symptom Management, vol. 63, no. 6, pp. 997-1005. https://doi.org/10.1016/j.jpainsymman.2022.02.013

TY - JOUR

T1 - Patient-reported outcomes during checkpoint inhibition

T2 - insight into symptom burden in daily clinical practice

AU - Koldenhof, J J

AU - van der Baan, F H

AU - Verberne, E G

AU - Kamphuis, A M

AU - Verheijden, R J

AU - Tonk, E H

AU - van Lindert, A S

AU - van der Stap, J

AU - Teunissen, S C

AU - Witteveen, P O

AU - Suijkerbuijk, K P

PY - 2022/6

Y1 - 2022/6

N2 - CONTEXT: While praised for inducing durable anti-tumour responses, immune checkpoint inhibitors (ICI) also cause immune-related adverse events (irAEs) that can vary in severity and affect health-related quality of life (HRQL).OBJECTIVES: This study was performed to provide insight into the course of symptoms and the influence of irAEs on HRQL measured with the treatment-specific Utrecht Symptom Diary Immunotherapy (USD-I).METHODS: In this observational cohort study, melanoma or non-small lung cancer (NSCLC) patients treated with PD(L)1-inhibitors between February 2016 and December 2018 were included. Data on symptoms, wellbeing and influence of side effects on HRQL were obtained using the patient-scored, treatment-specific USD-I, which was completed as part of routine care. Patients scored symptom intensity on a 0-10 numeric rating scale (NRS); NRS≥3 considered clinically relevant.RESULTS: A total of 162 melanoma (55%) or NSCLC (45%) patients completed 1493 USDs (median seven per patient). Most common patient-reported clinically relevant symptoms were: inactivity, fatigue, pain, cough and sleeping problems. Symptom prevalence decreased during treatment. Patients generally reported a low influence of side effects on HRQL. A higher number of clinically relevant symptoms at a certain time point correlated with poorer wellbeing.CONCLUSIONS: These data illustrate that ICI-treatment is generally well tolerated. However, especially the number of clinically relevant symptoms can impact patients wellbeing. Systematic use of an ICI-tailored PROM could create a window to discuss symptoms in a structured way which may promote personalized care during treatment.

AB - CONTEXT: While praised for inducing durable anti-tumour responses, immune checkpoint inhibitors (ICI) also cause immune-related adverse events (irAEs) that can vary in severity and affect health-related quality of life (HRQL).OBJECTIVES: This study was performed to provide insight into the course of symptoms and the influence of irAEs on HRQL measured with the treatment-specific Utrecht Symptom Diary Immunotherapy (USD-I).METHODS: In this observational cohort study, melanoma or non-small lung cancer (NSCLC) patients treated with PD(L)1-inhibitors between February 2016 and December 2018 were included. Data on symptoms, wellbeing and influence of side effects on HRQL were obtained using the patient-scored, treatment-specific USD-I, which was completed as part of routine care. Patients scored symptom intensity on a 0-10 numeric rating scale (NRS); NRS≥3 considered clinically relevant.RESULTS: A total of 162 melanoma (55%) or NSCLC (45%) patients completed 1493 USDs (median seven per patient). Most common patient-reported clinically relevant symptoms were: inactivity, fatigue, pain, cough and sleeping problems. Symptom prevalence decreased during treatment. Patients generally reported a low influence of side effects on HRQL. A higher number of clinically relevant symptoms at a certain time point correlated with poorer wellbeing.CONCLUSIONS: These data illustrate that ICI-treatment is generally well tolerated. However, especially the number of clinically relevant symptoms can impact patients wellbeing. Systematic use of an ICI-tailored PROM could create a window to discuss symptoms in a structured way which may promote personalized care during treatment.

KW - Cancer immunotherapy

KW - melanoma

KW - non-small cell lung carcinoma

KW - patient-reported symptoms

KW - supportive care

KW - symptom assessment

UR - http://www.scopus.com/inward/record.url?scp=85126900235&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2022.02.013

DO - 10.1016/j.jpainsymman.2022.02.013

M3 - Article

C2 - 35196557

SN - 0885-3924

VL - 63

SP - 997

EP - 1005

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

IS - 6

ER -

Patient-reported outcomes during checkpoint inhibition: insight into symptom burden in daily clinical practice

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this