Immunotherapy delays deterioration in health-related quality of life in metastatic NSCLC

The phase 3 POSEIDON study previously showed that the addition of immunotherapy (durvalumab or durvalumab/tremelimumab) to chemotherapy numerically improved survival of patients with metastatic non-small cell lung cancer (NSCLC). Patient-reported outcomes now indicate that deterioration of health-related quality of life (QoL) is delayed.

Immunotherapy is an important treatment modality for metastatic NSCLC. Dual blockade of PD-1/PD-L1 and CTLA-4 pathways may provide additive or synergistic effects. In the phase 3 POSEIDON trial (NCT03164616), first-line durvalumab plus chemotherapy significantly improved progression-free survival (PFS) versus chemotherapy alone in patients with metastatic NSCLC, with a positive trend for overall survival (OS) improvement that did not reach statistical significance [1]. In addition, first-line tremelimumab plus durvalumab plus chemotherapy demonstrated statistically significant and clinically meaningful improvements in both PFS and OS versus chemotherapy alone [1]. Now, Dr Edward Garon (David Geffen School of Medicine at UCLA, CA, USA) presented patient-reported outcomes of POSEIDON [2].

The trial randomised 1,013 patients with EGFR/ALK wildtype metastatic NSCLC 1:1:1 to durvalumab/tremelimumab /chemotherapy, durvalumab/chemotherapy, or chemotherapy alone, until progression of disease or unacceptable toxicity. Global health status/QoL, functioning, and symptoms were assessed as a secondary endpoint using EORTC QLQ-C30 and QLQ-LC13 questionnaires. Time to deterioration was also evaluated.

Compliance with the questionnaires was ≥60% (acceptable to good). Baseline global health status/QoL, functioning, and symptom scores were generally similar across treatment arms (see Table). Time to deterioration was longer with durvalumab/tremelimumab/chemotherapy and durvalumab/chemotherapy versus chemotherapy alone across nearly all patient-reported outcomes.

Table: Patient-reported outcomes in POSEIDON [2]



Dr Garon concluded that the addition of durvalumab with or without tremelimumab to chemotherapy improved efficacy while delaying deterioration in health-related QoL in patients with metastatic NSCLC. The observed delay in time to deterioration was generally similar in the durvalumab/tremelimumab/chemotherapy and durvalumab/chemotherapy arms.

1. Johnson ML, et al. Abstract PL02.01. WCLC 2021, 08–14 September.
2. Garon E, et al. Patient reported outcomes (PROs) with 1L durvalumab (D), with or without tremelimumab (T), plus chemotherapy (CT) in metastatic (m) NSCLC: Results from POSEIDON. Abstract 5MO. ELCC 2022 Virtual Meeting, 30 March–02 April.

 

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Posted on 25 May, 202215 February, 2024