Quality of life and mental health in real-world patients with resected stage III/IV melanoma receiving adjuvant immunotherapy

Authors

  • Sidsel Pedersen a Department of Oncology, National Center for Cancer Immune Therapy (CCIT-DK), Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
  • Rikke B. Holmstroem a Department of Oncology, National Center for Cancer Immune Therapy (CCIT-DK), Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
  • Annika von Heymann b Department of Oncology, Cancer Survivorship and Late Effects Research Center (CASTLE), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  • Laerke K. Tolstrup c Department of Oncology, Odense University Hospital, Odense, Denmark
  • Kasper Madsen a Department of Oncology, National Center for Cancer Immune Therapy (CCIT-DK), Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
  • Morten Aagaard Petersen d Department of Geriatrics and Palliative Medicine GP, Palliative Care Research Unit, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
  • Charlotte A. Haslund e Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
  • Christina H. Ruhlmann c Department of Oncology, Odense University Hospital, Odense, Denmark;f Department of Clinical Research, University of Southern Denmark, Odense, Denmark
  • Henrik Schmidt g Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
  • Christoffer Johansen b Department of Oncology, Cancer Survivorship and Late Effects Research Center (CASTLE), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
  • Inge Marie Svane a Department of Oncology, National Center for Cancer Immune Therapy (CCIT-DK), Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
  • Eva Ellebaek a Department of Oncology, National Center for Cancer Immune Therapy (CCIT-DK), Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark

DOI:

https://doi.org/10.1080/0284186X.2023.2165449

Keywords:

Melanoma, immunotherapy, adjuvant therapy, nivolumab, health-related quality of life

Abstract

Introduction

Treatment with immune checkpoint inhibitors (ICI) has expanded into the adjuvant setting enhancing the importance of knowledge on the immune-related toxicities and their impact on health-related quality of life (HRQoL). Large phase 3 trials of patients with resected Stage III/IV melanoma found no effect on HRQoL during adjuvant immunotherapy. This study investigates how HRQoL was affected during and after adjuvant immunotherapy in a real-world setting.

Methods

Patients with resected melanoma treated with adjuvant nivolumab from 2018 to 2021 in Denmark were identified using the Danish Metastatic Melanoma Database (DAMMED). The study was performed as a nationwide cross-sectional analysis as a questionnaire consisting of six different validated questionnaires on HRQoL, cognitive function, fatigue, depression, fear of recurrence, and decision regret was sent to all patients in March 2021. To evaluate HRQoL during and after adjuvant treatment, patients were divided into groups depending on their treatment status when answering the questionnaire; patients in active treatment for 0–6 months, patients in active treatment for >6 months, patients who ended treatment 0–6 months ago, and patients who ended treatment >6 months ago.

Results

A total of 271/412 (66%) patients completed the questionnaire. Patients who ended therapy 0–6 months ago had the lowest HRQoL and had more fatigue. Patients in active treatment for >6 months had lower HRQoL and more fatigue than patients who started treatment 0–6 months ago. Patients ending therapy >6 months ago had higher HRQoL and less fatigue compared to patients who ended therapy 0–6 months ago. Multivariable analysis showed an association between HRQoL and treatment status, comorbidity, civil status, and employment status.

Conclusions

Adjuvant nivolumab may affect some aspects of QoL, but the influence seems temporary. Patient characteristics, such as civil status, employment status, and comorbidity were associated with HRQoL.

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Published

2023-02-01

How to Cite

Pedersen, S., Holmstroem, R. B., von Heymann, A., Tolstrup, L. K., Madsen, K., Aagaard Petersen, M., … Ellebaek, E. (2023). Quality of life and mental health in real-world patients with resected stage III/IV melanoma receiving adjuvant immunotherapy. Acta Oncologica, 62(1), 62–69. https://doi.org/10.1080/0284186X.2023.2165449

Issue

Vol. 62 No. 1 (2023): Acta Oncologica

Section

Articles