Imagine this: Your own experiences and how you feel could actually predict how well you’ll fare against cancer. It’s not just about what doctors see; it’s about what you feel. A groundbreaking study published in Frontiers in Immunology reveals that patient-reported outcomes (PROs) – essentially, your own account of your health – are a surprisingly powerful tool in predicting survival for those undergoing immunotherapy for advanced non–small cell lung cancer (NSCLC). This is a big deal, and here’s why…
This research, spearheaded by the Cancer Nursing Today Editors, dives into data from two major clinical trials, EMPOWER-Lung 1 and EMPOWER-Lung 3 Part 2, focusing on the immunotherapy drug cemiplimab. In EMPOWER-Lung 1, patients with advanced NSCLC and a certain level of PD-L1 expression were treated with cemiplimab alone (283 patients). EMPOWER-Lung 3 included patients without specific genetic mutations, who received cemiplimab combined with chemotherapy (312 patients).
The researchers didn’t just look at the usual medical metrics. They assessed 25 different PROs using questionnaires designed to gauge quality of life, including the European Organization for Research and Treatment of Cancer Core Quality of Life and Quality of Life Lung Cancer 13 questionnaires. The results? Astonishing.
Fifteen of these PROs proved to be significantly linked to overall survival (OS), outperforming the traditional method of assessing a patient’s condition, the physician-defined Eastern Cooperative Oncology Group performance status (ECOG PS). Even more impressively, 14 PROs showed a significant association with progression-free survival (PFS), with 13 of them demonstrating better prognostic value than ECOG PS. Among these, patient-reported dyspnea (difficulty breathing) and physical functioning stood out, showing the highest prognostic value for both OS (c=0.635 and c=0.619, respectively) and PFS (c=0.593 and c=0.583, respectively). Think about that – your breath and your ability to move could be key indicators.
But here’s where it gets interesting… When patients were categorized based on their baseline physical functioning (low, intermediate, and high), the study revealed a stark difference. Those with high physical functioning at the start of the study had significantly better overall survival compared to those with low physical functioning, with a 59% lower risk of death. Their progression-free survival also saw a boost, with a 56% lower risk of death. This highlights how crucial it is to consider the patient’s perspective.
“These [findings] may help clinicians prioritize select PROs with the most meaningful and measurable outcomes that predict OS and PFS in advanced NSCLC, thereby minimizing the burden on the patient and increasing the quality of collected data,” the researchers stated. This means doctors could focus on the most important questions, making it easier for patients and getting more reliable data.
And this is the part most people miss… Beyond clinical trials, these findings underscore the potential value of PROs in everyday care. By actively reporting their symptoms, patients can become more involved in their treatment, potentially leading to better outcomes. Streamlining PRO assessment could also improve regulatory processes and create a more patient-centered approach in oncology.
But here’s a thought: Could this shift the balance of power in healthcare, giving patients a more active role in their treatment? Do you think patient-reported outcomes should be prioritized more in cancer care? Share your thoughts in the comments below!**