Patient-reported quality of life and mood in prolonged responders to immune checkpoint inhibitors for metastatic solid tumors.

Abstract

e24138 Background: Immune checkpoint inhibitors (ICIs) have transformed metastatic cancer care by enabling prolonged tumor control, creating a novel survivorship population living years with advanced disease. While tumor response rates are well documented, patient-reported outcomes including health-related quality of life (HRQoL) and psychological adjustment remain underexplored, particularly among real-world responders from middle-income settings where access barriers persist. Methods: This cross-sectional study, conducted between November 2020 and November 2021, included 38 adults (≥18 years) with metastatic solid tumors receiving immune checkpoint inhibitor therapy for at least six months without disease progression at a single Brazilian cancer center. Participants were selected through convenience sampling. Health-related quality of life was assessed using the validated Portuguese version of the Functional Assessment of Cancer Therapy–General (FACT-G, version 4), a 27-item instrument with total scores ranging from 0 to 108 across physical, social/family, emotional, and functional well-being domains. Symptoms of anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS), with subscale scores ≥8 indicating clinically relevant symptoms. Clinical and demographic data were extracted from medical records. Descriptive statistics, including means, standard deviations, and frequencies, were used, and results were compared with published normative data from oncology populations. Results: Participants (mean age 69 years; 61% male) showed preserved function (ECOG 0/1/2: 68/26/5%) across primaries (lung 26%, melanoma 24%, other 50%). Most received pembrolizumab monotherapy (66%); mean treatment duration 101 weeks (SD 63); immune-related adverse events (all grade 1-2) affected 37%. FACT-G scores aligned with norms: total 82 (SD 10); physical 22 (4), social/family 24 (4), emotional 19 (4), functional 18 (4). Differences versus references fell below minimal important differences (total <5 points, domains <2). HADS identified anxiety in 8% (n=3) and depression in 5% (n=2); no correlations observed between PROs, irAEs, or treatment duration. Conclusions: Metastatic cancer patients achieving durable ICI responses demonstrate normative HRQoL profiles with minimal psychological distress, suggesting favorable long-term tolerability. These findings support routine patient-reported outcome monitoring within comprehensive survivorship programs tailored to this population. FACT-G by domain. FACT-G Domain Mean (SD) Range Physical Well-Being 22 (4) 20-24 Social/Family 24 (4) 22-25 Emotional 19 (4) 18-21 Functional 18 (4) 17-20 Total Score 82 (10) 80-85