Quality of Life in Patients with Advanced Non–Small-Cell Lung Cancer: A Prospective real-world study

<bold>Introduction:</bold> Risk-benefit weighing is crucial for patients with advanced NSCLC in making treatment decisions as these could lead to adverse events with negative impact on quality of life (QoL). Treatment with immune checkpoint inhibitors (ICI) and chemotherapy (CT) combined, are considered to be worse for the QoL compared to mono CT and ICI treatment. However in trials QoL often remains underreported thus real world data is required to verify this. <bold>Aims and objectives:</bold> To assess and compare the real world QoL of stage III-IV NSCLC patients after initiation of first-line therapy. <bold>Methods:</bold> This real world prospective single-center cohort study included patients starting CT, ICI, or CT + ICI between November 2018 and February 2023. The EORTC QLQ-C30 and LC13 were completed at baseline and 12 weeks, treatment satisfaction was measured using the CTSQ. <bold>Results:</bold> 93 patients were included CT+ICI 59 (63.4%) CT: (17 (18.3%), ICI: 17 (18.3%). The median age was 69 years, 67% were male and most (93.5%) diagnosed at stage IV. 10 patients died before 12 weeks, 5 in both CT and CT+ICI groups. Baseline mean global health status was 67.59 (SD 23.16) in the CT+ICI group compared to the monotherapy ICI (58.33 (SD 19.34)) and CT (52.60 (SD 26.30)) groups (p=0.059). At 12 weeks, patients treated with CT+ICI showed a trend towards lower global health and similar physical scores as those treated with CT and ICI (p=0.052 and p=0.388). Patients treated with CT+ICI were satisfied with their treatment (70.24 (28.1)), similar to the CT and IC (p=0.951). <bold>Conclusions:</bold> QoL during potentially more toxic treatments with CT+ ICI remained similar compared to mono ICI or CT therapy in this prospective real world cohort.