Facilitating HRQOL Changes in Patients With ALK-Positive NSCLC

Photo Credit: Wildpixel

At the 2023 North American Conference on Lung Cancer, held December 1-3 in Chicago, Heather Law, MA, presented as part of a Poster Discussion session, a recap of “Associations of health-related quality of life (HRQoL) with daily functioning and communication with care teams in patients with ALK+ NSCLC.”

Law recently published a paper that addresses this topic, which we summarize here.

Establishing Meaningful Change Thresholds in Patient-Reported Outcomes among Patients with ALK-positive NSCLC in ALTA-1L Trial

Value Health. 2023 Nov 9:S1098-3015(23)06161-2.
Summary: Building on a previous ALTA-1L trial that highlighted superior health-related quality of life (HRQoL) outcomes with brigatinib compared to crizotinib in ALK+ non-small cell lung cancer (NSCLC) patients, this study sought to establish meaningful change thresholds (MCTs) for EORTC QLQ-C30 and EORTC QLQ-LC13, refining the earlier findings. Patients participating in the ALTA-1L trial were administered the EORTC QLQ-C30 and EORTC QLQ-LC13 questionnaires. Analysis methods included anchor-based analysis, graphical analysis, distribution-based analysis, longitudinal responder analysis, and time to deterioration. The patient-reported outcome cohort included 262 individuals who completed the EORTC QLQ-C30 at baseline and at least one follow-up. Both anchors (QLQ-C30 items addressing overall health and quality of life) exhibited correlations > 0.40 or < -0.40 with all functioning domains, fatigue, pain, appetite loss, and all dyspnea scores. Most scales, upon within-group analysis, indicated an MCT consistent with a 10-point cut-off for categorizing individual patient change, except for the three-item dyspnea measure. The brigatinib group exhibited significantly greater probabilities of improvement or stability in the EORTC QLQ-C30 Emotional Functioning, Appetite Loss, and Constipation domains compared to the crizotinib group. This study established MCTs for EORTC QLQ-C30 and QLQ-LC13 domains, applicable to future investigations, and reaffirmed the superior HRQoL outcomes of brigatinib over crizotinib in NSCLC patients.