Quality of Life Found to Be a High Priority in Treatment Decision-Making for Patients with NSCLC

Cancer is attributed to 10 million deaths in 2020 and is the second leading cause of death globally.¹ Quality of life (QOL) is one of the main goals of cancer treatment, with palliative care demonstrated to improve symptoms, psychological distress, and QOL.¹ Terminal cancer can have a broadly typical disease trajectory with a period of preserved functional status followed by deterioration and worsening symptoms as the end of life approaches.¹ Patient-reported outcomes are important to consider as they can help identify new or worsening symptoms.¹

Lung cancer is typically diagnosed at an advanced stage, with patients with metastatic cancer having a <1-year life expectancty.¹ Patients with lung cancer also are reported to have more symptoms than patients with other types of cancer.¹ For patients with advanced non–small-cell lung cancer (NSCLC) who have had multiple lines of therapy, their poor prognosis and few remaining treatment options impact their QOL significantly.

A study using data on patients’ perceptions of their QOL included patients with advanced NSCLC from Europe, North America, and South America. Patient advocacy advisory boards were asked about treatment side effects and QOL and how these impacted treatment decision-making and care.

Independence was a key component in QOL as cancer symptoms and treatment toxicities have a major impact on patients being able to maintain activities of daily living. Physical and mental fatigue was reported as particularly burdensome for patients who had received multiple lines of therapy.

It was noted that more accessible care, such as telehealth appointments or oral therapies, was needed that fits into patient and caregiver routines. Palliative care was highlighted for its effect on improving QOL, highlighting the need for health systems to incorporate palliative care into treatment management.

Regular assessment of individual treatment priorities was recommended as subsequent lines of therapy are pursued, as independence and QOL become prioritized at the later stages of cancer therapy. Patient-provider communication was stressed to ensure that independence and QOL remain a priority during all stages of cancer therapy.

Reference:

1. Kristensen A, Grønberg BH, Fløtten Ø, Kaasa S, Solheim TS. Trajectory of health-related quality of life during the last year of life in patients with advanced non-small–cell lung cancer. Support Care Cancer. 2022;30(11):9351-9358.

Source: Wheatley-Price P, Stern Ferris A, Holtz De Camargo Barros L, et al. Insights into the advanced non-small cell lung cancer patient journey: treatment decision-making, preferences, and quality of life considerations. J Clin Oncol. 2022:40(suppl 16)S:e21129.