Prospective Evaluation of Health-Related Quality of Life in Patients with Metastatic Urothelial Carcinoma Undergoing Immunotherapy with Pembrolizumab: Symptom Burden Can Predict Survival

Abstract

<b><i>Introduction:</i></b> Despite the fact that guidelines recommend monitoring of quality of life during all phases of treatment in urothelial carcinoma, prospective data about health-related quality of life (HRQoL) in metastatic urothelial carcinoma undergoing immunotherapy are sparse. Consequently, we performed a prospective clinical pilot study about HRQoL using the Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator (FACT-ICM) questionnaire. <b><i>Materials and Methods:</i></b> Formally, this study is a prospective uni-centric noninterventional observation from January 2021 to December 2021. <b><i>Results:</i></b> Fourteen patients with a mean age of 73.9 years (SD 8.8) participated in the study. The physical well-being subscale of FACT-G is most impaired during therapy with mean scores of 7.5, 6.2, and 4.0 followed by the emotional well-being. The FACT-G total score is stable during therapy with mean scores of 51.1, 50.4, and 48.0 and it is not significantly decreasing during therapy (<i>p</i> = 0.317). Furthermore, the symptom burden of these patients is low and not significantly changing over time (<i>p</i> = 0.500), but survival decreases significantly if symptom burden is high (FACT-ICM score over 40; <i>p</i> < 0.001). <b><i>Conclusion:</i></b> Physical and emotional needs have a strong impact on HRQoL and should be dealt with during treatment. If symptom burden is high, survival decreases. This needs further evaluation.

Real‐world treatment patterns and quality of life among patients with locally advanced or metastatic urothelial carcinoma living in Saudi Arabia, South Korea, Taiwan, and Turkey

“…Real‐world studies conducted in the United States of America before the availability of most novel agents, found that patients who did not receive treatment after discontinuing first‐ or second‐line PD‐1/L1 inhibitor therapy had low overall survival, substantial resource use, economic burden, and QoL impairment 32,33 . Together, these findings highlight the importance of increasing access to effective later treatment lines, managing symptom burden, which can affect outcomes, and addressing QoL in patients with la/mUC 34 …”

“…32,33 Together, these findings highlight the importance of increasing access to effective later treatment lines, managing symptom burden, which can affect outcomes, and addressing QoL in patients with la/mUC. 34…”