• Josephine J Koldenhof, Frederieke H van der Baan, Elisabeth G Verberne, Annemarleen M Kamphuis, Rik J Verheijden, Erwin H Tonk, Anne S van Lindert, Janneke van der Stap, Saskia C Teunissen, Petronella O Witteveen, and Karjin P Suijkerbuijk.
• Department of Medical Oncology (J.J.K., E.G.V., A.M.K, R.J.V., E.H.T., P.O.W., K.P.S.), University Medical Center Utrecht, University Utrecht, The Netherlands. Electronic address: j.koldenhof@umcutrecht.nl.
• J Pain Symptom Manage. 2022 Jun 1; 63 (6): 997-1005.

ContextWhile praised for inducing durable anti-tumour responses, immune checkpoint inhibitors (ICI) also cause immune-related adverse events (irAEs) that can vary in severity and affect health-related quality of life (HRQL).ObjectivesThis study was performed to provide insight into the course of symptoms and the influence of irAEs on HRQL measured with the treatment-specific Utrecht Symptom Diary Immunotherapy (USD-I).MethodsIn this observational cohort study, melanoma or non-small lung cancer (NSCLC) patients treated with PD(L)1-inhibitors between February 2016 and December 2018 were included. Data on symptoms, wellbeing and influence of side effects on HRQL were obtained using the patient-scored, treatment-specific USD-I, which was completed as part of routine care. Patients scored symptom intensity on a 0-10 numeric rating scale (NRS); NRS≥3 considered clinically relevant.ResultsA total of 162 melanoma (55%) or NSCLC (45%) patients completed 1493 USDs (median seven per patient). Most common patient-reported clinically relevant symptoms were: inactivity, fatigue, pain, cough and sleeping problems. Symptom prevalence decreased during treatment. Patients generally reported a low influence of side effects on HRQL. A higher number of clinically relevant symptoms at a certain time point correlated with poorer wellbeing.ConclusionsThese data illustrate that ICI-treatment is generally well tolerated. However, especially the number of clinically relevant symptoms can impact patients wellbeing. Systematic use of an ICI-tailored PROM could create a window to discuss symptoms in a structured way which may promote personalized care during treatment.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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