Lifestyle and Quality of Life in cancer patients treated with immunotherapy

epidemiology immunotherapy lifestyle

Prof. dr. G.H. de Bock
Drs. P.C. Vinke

Nature of the research:
This research is embedded within the databiobank OncoLifeS and the prospective cohort study QUALITOP.

Fields of study:
epidemiology oncology

Background / introduction
The introduction of immune checkpoint inhibitors (ICIs) has led to significant improvement in clinical outcomes of among others advanced melanoma and non-small cell lung cancer(1,2), but new treatments also come with new challenges. Although the risk of (severe) adverse events is lower in comparison with chemotherapy (3), adverse events are still frequent for ICI treatment and occur in 70-90% of patients depending on the ICI antibody (4). In combination with the intended long continuation of the treatment (up to two years), ICIs may impair health-related quality of life of the patients.

Research so far does suggest that on average, ICIs have a smaller adverse effect on health-related quality of life during the course of treatment than other therapies (5). Yet, a substantial proportion of patients treated with ICIs does experience a deterioration of HrQoL or symptom burden (6,7). Better understanding of the determinants of changes in HrQoL upon ICI treatment may help to identify patients at greater risk for HrQoL deterioration in the future. In this project, we aim to monitor quality of life in patients treated with ICIs, and investigate whether lifestyle factors such as smoking and alcohol consumption influence the course of quality of life throughout treatment.
Research question / problem definition
What is the association of lifestyle factors, such as smoking and alcohol intake, with quality of life in patients diagnosed with cancer who are being treated with immune checkpoint inhibitors?
Within the project, students will first further define a research question of interest, based on literature, focused on a specific lifestyle factor and potentially a specific type of cancer. Lifestyle and health-related quality of life data is already being collected within the OncoLifeS databiobank and the QUALITOP study. Students will need to enrich the database with clinical data, by extracting this from patient files. After this, the data will be analyzed to answer the selected research question.
1. Pan C, Liu H, Robins E, Song W, Liu D, Li Z, et al. Next-generation immuno-oncology agents: Current momentum shifts in cancer immunotherapy. J Hematol Oncol. 2020;13(1):1–16.

2. Robert C. A decade of immune-checkpoint inhibitors in cancer therapy. Nat Commun. 2020;11(1):10–2.

3. Magee DE, Hird AE, Klaassen Z, Sridhar SS, Nam RK, Wallis CJD, et al. Adverse event profile for immunotherapy agents compared with chemotherapy in solid organ tumors: a systematic review and meta-analysis of randomized clinical trials. Ann Oncol. 2020;31(1):50–60.

4. Michot JM, Bigenwald C, Champiat S, Collins M, Carbonnel F, Postel-Vinay S, et al. Immune-related adverse events with immune checkpoint blockade: A comprehensive review. Eur J Cancer. 2016;54:139–48.

5. Hall ET, Singhal S, Dickerson J, Gabster B, Wong H nei, Aslakson RA, et al. Patient-Reported Outcomes for Cancer Patients Receiving Checkpoint Inhibitors: Opportunities for Palliative Care—A Systematic Review. J Pain Symptom Manage. 2019;58(1):137-156.e1.

6. Schadendorf D, Dummer R, Hauschild A, Robert C, Hamid O, Daud A, et al. Health-related quality of life in the randomised KEYNOTE-002 study of pembrolizumab versus chemotherapy in patients with ipilimumab-refractory melanoma. Eur J Cancer. 2016;67:46–54.

7. Brahmer JR, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Health-related quality-of-life results for pembrolizumab versus chemotherapy in advanced, PD-L1-positive NSCLC (KEYNOTE-024): a multicentre, international, randomised, open-label phase 3 trial. Lancet Oncol. 2017;18(12):1600–9.
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