Electronic patient-reported outcomes (ePRO) in patients with advanced melanoma receiving immune checkpoint inhibitors: Insights from the Canopy ePRO system.

Abstract

11126 Background: Health-related quality of life (HRQoL) outcomes are prognostic in melanoma. There is little data comparing HRQoL during nivolumab (nivo) and pembrolizumab (pembro) exposure in patients with melanoma. Electronic patient-reported outcomes (ePROs) provide valuable insights into HRQoL; this study reports on ePRO data from community oncology practices using the Canopy Remote Therapeutic Monitoring (Canopy RTM) platform to explore ePROs in patients with melanoma treated with nivo, pembro, or nivo/ipi. Methods: The Canopy RTM system is a proprietary, cloud‐based platform that directly integrates with electronic medical records systems to enable RTM. Patients using Canopy RTM could submit symptom reports using smart devices or a phone system. This study retrospectively analyzed ePRO data of patients with melanoma treated with nivo, pembro, or nivo/ipi, excluding those who received chemotherapy during index treatment. Symptom and broad symptom category reporting during each treatment was assessed using descriptive statistics. Sensitivity analyses were performed, including limiting time at risk of symptom reports to 60 days following index and excluding patients with record of exposure to ipilimumab prior to index. Results: 386 patient treatments were included: 140 receiving nivo; 169, pembro; and 57, nivo/ipi. Median age was 66, 69, 61 years across the nivo, pembro, and nivo/ipi groups, respectively. Median time on therapy was 285, 269, 49 days for nivo, pembro, and nivo/ipi, respectively. Compared to pembro, nivo treatment was associated with higher incidence of infection symptoms, difficulty with activities of daily living, gastrointestinal symptoms, and pain (Table 1). Despite significantly shorter time on therapy, more patients reported infection and rash during nivo/ipi treatment than during nivo treatment. Sensitivity analysis limiting time at risk of symptoms to 60 days following index revealed similar findings, albeit with greater proportions of patients treated with nivo/ipi reporting symptoms across most symptoms. Conclusions: Pembro monotherapy may be associated with a lower incidence of some symptoms compared to nivo (+/- ipi), while nivo monotherapy has fewer symptoms than nivo/ipi treatment. Further research is warranted to confirm these findings. Select symptoms and symptom categories (composites) reported during treatment. Symptom or composite Pembrolizumab Nivolumab Nivo/Ipi Infection (composite) 57 (34%) 67 (48%) 31 (54%) Cough 25 (15%) 30 (21%) 14 (25%) Fever under 100.4F 6 (3.6%) 10 (7.1%) 7 (12%) Difficulty breathing 27 (16%) 26 (19%) 13 (23%) Gastrointestinal (composite) 69 (41%) 67 (48%) 30 (53%) Indigestion 13 (7.7%) 16 (11%) 5 (8.8%) Diarrhea 36 (21%) 31 (22%) 14 (25%) Activities of daily living (composite) 84 (50%) 88 (63%) 34 (60%) Rash 22 (13%) 20 (14%) 15 (26%)