Year: 2018
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: The aim of this meta-analysis was to compare patient-reported outcomes (PROs) between programmed death receptor-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors and standard-of-care therapy in patients with advanced cancer. METHODS: We searched randomized controlled trials (RCTs) comparing single-agent PD-1/PD-L1 inhibitors (nivolumab, pembrolizumab, atezolizumab, avelumab, or durvalumab) with standard-of-care therapy in patients with advanced cancer reporting PROs with generic measures: the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items (QLQ-C30) and the EuroQol Five Dimensions Questionnaire. The summary outcomes were changes in PROs from baseline to follow-up within and between treatment groups and time to deterioration (TTD) in PROs based on clinically meaningful change. RESULTS: = .011). Similarly, significantly better outcomes were noted with PD-1/PD-L1 inhibitors on most of the other PRO measures. CONCLUSION: PD1/PD-L1 inhibitors maintained health-related quality of life to a greater degree and had less worsening in symptoms than standard-of-care therapy even though patients on these immune modulators were on treatment longer. The better PRO profile further supports the clinical benefit of this treatment strategy for advanced cancer. IMPLICATIONS FOR PRACTICE: We conducted a systematic review and meta-analysis to compare patient-reported outcomes (PROs) of programmed death receptor-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors and standard-of-care therapy in patients with advanced cancer. PD-1/PD-L1 inhibitors were associated with consistently smaller PRO score deterioration from baseline to follow-up for different health-related quality-of-life and symptoms scales. In addition, the time to deterioration in multiple PRO domains was significantly longer with PD-1/PD-L1 inhibitors. Taken together, these findings indicate that the patients treated with PD-1/PD-L1 inhibitors maintained health-related quality of life to a greater degree and had less symptom burden compared with those treated with standard-of-care therapy.
Source: The Oncologist
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2904515591