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Grumberg V, Cotté FE, Giroux-Leprieur E, Gaudin AF, Lebbé C, Borget I. Clinical benefit of anti-PD-(L)1 immunotherapies in advanced cancer in France: a population-based estimate from 2014 to 2021. ESMO Open 2024; 9:102240. [PMID: 38335904 PMCID: PMC10937192 DOI: 10.1016/j.esmoop.2024.102240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND In France, the potential benefit of new treatments is initially evaluated by the Haute Autorité de Santé to determine reimbursement and pricing, but rarely afterwards. Although immunotherapies (ITs) have considerably improved the survival of patients, few data are available on their long-term benefit at a population-treated level. The present retrospective study aimed to assess the clinical benefit of ITs compared to the previous standards of care (SoCs) in France from 2014 to 2021. MATERIALS AND METHODS To do this, we analyzed all ITs from the anti-programmed cell death protein 1/programmed death-ligand 1 [anti-PD-(L)1] class used in monotherapy or in association with another treatment available in early access or reimbursed in France between 2014 and 2021, regardless of indication. The number of patients initiating an IT was retrieved by year, drug and indication. Using extrapolated Kaplan-Meier curves, utility scores and the population treated, the clinical benefit was expressed as the number of deaths prevented (DP), life-years (LYs) and quality-adjusted life years (QALYs) gained compared to previous SoC. RESULTS Across the period, five ITs were marketed in 21 indications related to eight primary tumor sites. Between 2014 and 2021, 132 924 patients initiated an IT. By December 2021, 16 173 (13 804-17 141) deaths were delayed compared to previous SoC, mainly in lung cancer. Compared to their SoC, ITs provided a gain of 37 316 (33 581-41 048) additional LYs and 27 709 (23 784-30 450) additional QALYs. Lung cancer was the driver indication with 70.6% of LYs and 68.4% of QALYs gained followed by melanoma with 18.7% and 20.4% of the gain, respectively. CONCLUSIONS Significant gains in DP, LYs and QALYs have been observed in France following the introduction of ITs.
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Affiliation(s)
- V Grumberg
- Bristol Myers Squibb France, Rueil-Malmaison; Oncostat, U1018, CESP, Inserm, Paris-Saclay University, 'Ligue Contre le Cancer' Team, Villejuif.
| | - F-E Cotté
- Bristol Myers Squibb France, Rueil-Malmaison
| | - E Giroux-Leprieur
- Department of Respiratory Diseases and Thoracic Oncology, Paris-Saclay University, UVSQ, EA4340, APHP-Hôpital Ambroise Paré, Boulogne Billancourt
| | - A-F Gaudin
- Bristol Myers Squibb France, Rueil-Malmaison
| | - C Lebbé
- Université Paris Cite, APHP Dermato-oncology, Cancer Institute APHP Nord Paris Cité, INSERM U976, Saint Louis Hospital, Paris
| | - I Borget
- Oncostat, U1018, CESP, Inserm, Paris-Saclay University, 'Ligue Contre le Cancer' Team, Villejuif; Biostatistics and Epidemiology Office, Gustave Roussy, Paris-Saclay University, Villejuif, France
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Assié JB, Grumberg V, Reynaud D, Gaudin AF, Batisse A, Jolivel R, Jouaneton B, Cotté FE, Chouaïd C. Characteristics, management, and healthcare resources of patients with advanced non-small-cell lung cancer surviving 5 years after nivolumab treatment initiation: A national database analysis. Respir Med Res 2023; 84:101051. [PMID: 37897879 DOI: 10.1016/j.resmer.2023.101051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Data on long-term survivors with advanced non-small-cell lung cancer (NSCLC) treated with nivolumab are available from randomized trials. Characteristics, management, and healthcare resources of those patients need to be confirmed with real-world data. METHODS The UNIVOC retrospective observational study included all patients with advanced NSCLC recorded in the French national hospital database starting nivolumab in 2015 and followed them until December 2020. The Kaplan-Meier method estimated the overall survival (OS). A machine learning approach identified patients with similar treatment sequences. RESULTS Within the 3,050 patients who had nivolumab initiation,5-year OS rate was 14.6 % (95 %CI 13.3 %-16.2 %). In total, data covering at least 5 years of follow-up were retrieved for 231 surviving patients. Survivors were younger, often female and had fewer comorbidities than non-survivors. Three clusters of patients with different nivolumab treatment durations were identified: 1/ Continuous nivolumab treatment; 2/ Long period of nivolumab treatment followed by chemotherapy or no treatment; 3/ Short period of nivolumab treatment then chemotherapy or no treatment. At 5 years, 61.0 % of survivors were no longer receiving systemic therapy, 26.4 % were treated with nivolumab, 8.7 % chemotherapy, and 3.9 % other immunotherapies. Among 5-y survivor patients, the average number of hospitalisations per patient decreased from 23.4 to 12.8 between the 1st and the 5th year. In the 5th year, 46 % of patients had no more hospitalization for lung cancer. CONCLUSIONS This large nationwide study confirms the long-term benefit of nivolumab treatment for advanced NSCLC patients in the real-world setting, with a 5-year survival rate similar to that reported in clinical trials.
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Affiliation(s)
- Jean-Baptiste Assié
- Functional Genomics of Solid Tumors Laboratory, Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France; Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Valentine Grumberg
- Bristol Myers Squibb France, 3 rue Joseph Monier, Rueil-Malmaison 92500, France; Oncostat - U1018, INSERM, Paris Saclay University, "Ligue Contre le Cancer" Labeled Team, Villejuif, France.
| | - Dorothée Reynaud
- Bristol Myers Squibb France, 3 rue Joseph Monier, Rueil-Malmaison 92500, France
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Grumberg V, Chouaïd C, Gaudin AF, Le Tourneau C, Marabelle A, Bongiovanni-Delarozière I, Cotté FE, Borget I. Organizational Impact of Immunotherapies in Advanced Cancers in France. JCO Glob Oncol 2023; 9:e2300026. [PMID: 37595168 PMCID: PMC10846793 DOI: 10.1200/go.23.00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/09/2023] [Accepted: 06/29/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE In 2020, the French National Authority for Health (Haute Autorité de Santé) published a methodologic guide called organizational impact (OI) cartography to define and structure assessment of the OI of health technologies. As immunotherapies are associated with extended survival and improved quality of life in advanced cancer, we aimed to identify OIs that immunotherapies had on health care systems and professionals. To our knowledge, we suggest the first implementation for OI assessment on the basis of the cartography. METHODS A literature review was conducted, and interviews with health care professionals (HCPs) were performed to identify OIs of immunotherapies. They were asked if immunotherapies had OIs classified into three macrocriteria, namely, impact on the care process (six criteria), impact on capacities and skills required (six criteria), and impact on society (four criteria). If an OI was mentioned for a criterion, information on its impact (minor/moderate/major) and its timing was collected. We considered that an OI existed when 75% of HCPs mentioned an impact for a given criterion. RESULTS Overall, 27 HCPs were interviewed. For 12 of 16 criteria, most HCPs mentioned an impact, whereas the literature identified impacts for 11 criteria. Four criteria (skills and transfer between HCPs, scheduling capabilities, and social relationship) had consensus among HCPs and a high impact; two criteria (rhythm or care duration, working/living conditions) showed consensus but a moderate impact; two criteria (funding and scheduling capabilities cross-structure) had a high impact but no consensus. For eight criteria (as environment or inequity), there was no consensus and moderate impact. CONCLUSION The introduction of immunotherapies for advanced cancer has had an important OI in France, regarding capacities and skills. Further research using qualitative analysis of interviews will provide more information regarding OI.
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Affiliation(s)
- Valentine Grumberg
- Bristol Myers Squibb France, Rueil-Malmaison, France
- Oncostat, U1018, CESP, Inserm, Paris-Saclay University, “Ligue Contre le Cancer” Labeled Team, Villejuif, France
| | - Christos Chouaïd
- Department of Chest Medicine, Créteil University Hospital, Créteil, France
- INSERM U955, UPEC, IMRB, Créteil, France
| | | | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
- INSERM U900 Research Unit, Paris-Saclay University, Saint-Cloud, France
| | - Aurélien Marabelle
- Drug Development Department (DITEP), INSERM U1015, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | | | | | - Isabelle Borget
- Oncostat, U1018, CESP, Inserm, Paris-Saclay University, “Ligue Contre le Cancer” Labeled Team, Villejuif, France
- Department of Biostatistics and Epidemiology, Gustave Roussy, Paris-Saclay University, Villejuif, France
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Assié JB, Chouaïd C, Nunes H, Reynaud D, Gaudin AF, Grumberg V, Jolivel R, Jouaneton B, Cotté FE, Duchemann B. Outcome following nivolumab treatment in patients with advanced non-small cell lung cancer and comorbid interstitial lung disease in a real-world setting. Ther Adv Med Oncol 2023; 15:17588359231152847. [PMID: 36743523 PMCID: PMC9893351 DOI: 10.1177/17588359231152847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023] Open
Abstract
Background Up to 10% of patients with advanced non-small cell lung cancer (aNSCLC) have pre-existing interstitial lung disease (ILD). These patients are usually excluded from immunotherapy clinical trials. Consequently, knowledge on outcomes following nivolumab treatment in these patients remains limited. The primary objective of this study was to evaluate survival outcome following nivolumab treatment in ILD patients with pre-treated aNSCLC in the real-world setting. Patients and methods The study included all patients with aNSCLC recorded in the French hospital database, starting nivolumab in 2015-2016. Patients were stratified by pre-existing ILD and three subgroups were studied [auto-immune or granulomatous (AI/G) ILD, other known causes ILD and idiopathic ILD]. Time to discontinuation of nivolumab treatment [time to treatment duration (TTD)] and overall survival (OS) were estimated using Kaplan-Meier survival analysis. Results Of 10,452 aNSCLC patients initiating nivolumab, 148 (1.4%) had pre-existing ILD. Mean age at nivolumab initiation was 64.6 ± 9.4 years in ILD and 63.8 ± 9.6 years in non-ILD. Compared to non-ILD, patients in the ILD group were more frequently men (p < 0.05) and had more comorbidities (p < 0.001). There was no significant difference between ILD and non-ILD groups for median TTD (2.5 versus 2.8 months; p = 0.6) or median OS (9.6 versus 11.9 months; p = 0.1). Median OS in AI/G ILD (n = 14), other known causes ILD (n = 75), and idiopathic ILD (n = 59) were 8.6, 10.7, and 9.6 months, respectively. Conclusion In this large cohort of aNSCLC patients with ILD, outcomes are similar to those obtained in the non-ILD population. Immunotherapy could be beneficial for these patients.
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Affiliation(s)
- Jean-Baptiste Assié
- Functional Genomics of Solid Tumors Laboratory, Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France,Centre Hospitalier Intercommunal Créteil, Créteil, France
| | | | - Hilario Nunes
- Department of Respiratory Medicine, Centre de Référence des Maladies Pulmonaires Rares, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France
| | | | | | | | | | | | | | - Boris Duchemann
- Department of Thoracic and Medical Oncology, Avicenne Hospital, Université Sorbonne Paris Nord, Paris, France,Laboratoire d’Immunomonitoring en Oncologie, INSERM US23, CNRS UMS 3655, Institut Gustave Roussy, Villejuif, France
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Borget I, Chouaid C, Cotté FE, Gaudin AF, Grumberg V. 1330P Organizational impact of immune-checkpoint inhibitors in advanced cancers in France: Final analysis. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Chouaïd C, Grumberg V, Batisse A, Corre R, Giaj Levra M, Gaudin AF, Prodel M, Lortet-Tieulent J, Assié JB, Cotté FE. Machine Learning-Based Analysis of Treatment Sequences Typology in Advanced Non-Small-Cell Lung Cancer Long-Term Survivors Treated With Nivolumab. JCO Clin Cancer Inform 2022; 6:e2100108. [PMID: 35113656 PMCID: PMC8824409 DOI: 10.1200/cci.21.00108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Immune checkpoint inhibitors substantially changed advanced non-small-cell lung cancer (aNSCLC) management and can lead to long-term survival. The aims of this study were (1) to use a machine learning method to establish a typology of treatment sequences on patients with aNSCLC who were alive 2 years after initiating a treatment with anti-programmed death-ligand 1 monoclonal antibody nivolumab and (2) to describe the patients' characteristics according to the typology of treatment sequences. MATERIALS AND METHODS This retrospective observational study was based on data from the comprehensive French hospital discharge database for all patients with lung cancer with at least one line of platinum-based chemotherapy, starting nivolumab between January 1, 2015, and December 31, 2016, and alive 2 years after nivolumab treatment initiation. Patients were followed until December 31, 2018. A typology of most common treatment sequences was established using hierarchical clustering with time sequence analysis. RESULTS Two thousand two hundred twelve study patients were, on average, 63.0 years old, 69.9% of them were men, and 61.9% had a nonsquamous cell carcinoma. During the 2 years after nivolumab treatment initiation, clusters of patients with four basic types of treatment sequences were identified: (1) almost continuous nivolumab treatment (44% of patients); (2) nivolumab most of the time followed by a treatment-free interval or a chemotherapy (15% of patients); and a short or medium nivolumab treatment, followed by (3) a long systemic treatment-free interval (17% of patients) or (4) a long chemotherapy (23% of patients). CONCLUSION This machine learning approach enabled the identification of a typology of four representative treatment sequences observed in long-term survival. It was noted that most long-term survivors were treated with nivolumab for well over 1 year.
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Affiliation(s)
- Christos Chouaïd
- Service de pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | | | - Romain Corre
- Centre Hospitalier Intercommunal de Cornouaille, Quimper, France
| | - Matteo Giaj Levra
- Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France
| | | | | | | | - Jean-Baptiste Assié
- Service de pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Centre de Recherche des Cordeliers, Inserm, Université de Paris, Sorbonne Université, Functional Genomics of Solid Tumors Laboratory, Paris, France
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Grumberg V, Chouaïd C, Cotté FE, Jouaneton B, Jolivel R, Gaudin AF, Reynaud D, Assié JB, Borget I. Long-term hospital resource utilization and associated costs of care for patients initiating nivolumab in advanced non-small cell lung cancer in France. J Med Econ 2022; 25:691-699. [PMID: 35587018 DOI: 10.1080/13696998.2022.2079291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES In advanced cancers, healthcare resource utilization (HCRU) and costs usually increase until death. However, few studies have measured HCRU over time in patients treated with immunotherapies. The objective was to describe the evolution of HCRU and costs over four years for patients with advanced non-small cell lung cancer (aNSCLC) initiating nivolumab. MATERIALS AND METHODS Based on the French hospital reimbursement database, all aNSCLC patients initiating nivolumab in the 2nd line or later in 2015 or 2016 were followed until 2019. HCRU (including hospitalizations and hospital visits) and costs (payer perspective) were described annually after nivolumab initiation. Trends in HCRU were analyzed with the Mann-Kendall test. As most patients did not reach the four-year follow-up, cost-analysis was performed without adjustment throughout, without adjustment in uncensored cases only or with adjustment using for all patients using the Bang&Tsiatis method. RESULTS 10,452 patients initiating nivolumab were evaluated. The percentage of patients hospitalized or with hospital visits decreased (p < .001) over the four-year follow-up with the exception of consultations. The number of hospital visits per patient decreased from 23.3 in Y1 to 13.2 in Y4 without adjustment and 18.3 with adjustment (p < .001). The overall hospitalization duration per patient (days) decreased from 36.0 (Y1) to 14.9 (Y4-unadjusted) and 20.5 (Y4-adjusted) (p < .001). Annual per capita costs also decreased. The method without adjustment provided the lowest cost over time (€44,404 (Y1), €32,206 (Y2); €28,552 (Y3); €18,841(Y4)) while the Bang&Tsiatis method presented the highest cost (€45,002 (Y1), €36,330 (Y2); €35,080 (Y3); €28,931 (Y4)). CONCLUSION HCRU and costs for NSCLC patients treated with nivolumab decreased over time. Cost estimates are dependent on the statistical method used to take into account uncertainty, but costs decreased over time whatever the method used.
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Affiliation(s)
- Valentine Grumberg
- Bristol Myers Squibb France, Rueil-Malmaison, France
- Oncostat, CESP, INSERM U1018, Paris-Saclay University, "Ligue Contre le Cancer" labeled team, Villejuif, France
| | - Christos Chouaïd
- Department of Chest Medicine, Créteil University Hospital, Créteil, France
- INSERM U955, UPEC, IMRB, Créteil, France
| | | | | | | | | | | | - Jean-Baptiste Assié
- Department of Chest Medicine, Créteil University Hospital, Créteil, France
- INSERM U1138 Centre de Recherche des Cordeliers (CRC), Paris, France
| | - Isabelle Borget
- Oncostat, CESP, INSERM U1018, Paris-Saclay University, "Ligue Contre le Cancer" labeled team, Villejuif, France
- Biostatistics and Epidemiology Office, Direction of Clinical Research, Gustave Roussy, Paris-Saclay University, Villejuif, France
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Assie JB, Chouaid C, Nunes H, Reynaud D, Gaudin AF, Grumberg V, Jolivel R, Jouaneton B, Cotté FE, Duchemann B. 101P Nivolumab outcomes in interstitial lung disease patients with advanced non-small cell lung cancer in French real-world setting. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.10.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Assié JB, Corre R, Levra MG, Calvet CY, Gaudin AF, Grumberg V, Jouaneton B, Cotté FE, Chouaïd C. Nivolumab treatment in advanced non-small cell lung cancer: real-world long-term outcomes within overall and special populations (the UNIVOC study). Ther Adv Med Oncol 2020; 12:1758835920967237. [PMID: 33403011 PMCID: PMC7745546 DOI: 10.1177/1758835920967237] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/23/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To describe long-term outcomes of patients treated with nivolumab for advanced non-small cell lung cancer (aNSCLC) in everyday clinical practice in France, with a focus on patients aged ⩾80 years, patients with renal impairment and patients with brain metastases. METHODS The study included all patients with aNSCLC recorded in the French national hospital database, starting nivolumab in 2015-2016 and followed until December 2018. Patients were stratified by age, the presence of renal impairment and brain metastasis, as documented in the hospital discharge summaries. Information was retrieved on demographics, comorbidities and treatment history at baseline. Time to discontinuation of nivolumab treatment and overall survival were estimated using Kaplan-Meier survival analysis. RESULTS Overall, 10,452 patients were included, of whom 514 were octogenarians, 479 had renal impairment and 1800 had brain metastases at baseline. Median duration of nivolumab treatment was 2.8 months in the overall population and in both the octogenarian and renally impaired subgroups, and 2.3 months in patients with brain metastases. Median overall survival in these patient groups was 11.7 months (95% confidence interval: 11.3-12.2), 11.7 months (11.3-12.1), 11.7 months (11.3-12.2) and 9.9 months (9.0-10.9) respectively. Three-year overall survival rates were 19.1% (18.1-20.2) in the overall population, 16.5% (11.6-23.4) in octogenarians, 15.9% (11.8-21.4) in patients with renal impairment and 21.7% (19.4-24.2) in those with brain metastases. CONCLUSION This large nationwide retrospective real-life cohort provided narrow estimates of long-term overall survival, which reached 19% at 3 years, consistent with data from phase III trials of nivolumab. Survival rates were comparable in the three special populations of interest and the overall population.
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Affiliation(s)
- Jean-Baptiste Assié
- Service de Pneumologie, CHI Créteil, UPEC, Créteil, France
- Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université de Paris, Functional Genomics of Solid Tumours Laboratory, Paris, France
| | - Romain Corre
- Service de Pneumologie, Centre Hospitalier Intercommunal de Quimper, Quimper, France
| | - Matteo Giaj Levra
- Thoracic Oncology Unit, Centre Hospitalier Universitaire Grenoble Alpes (CHUGA), Grenoble, France
- Institute for Advanced Biosciences INSERM U1209 CNRS UMR5309 Université Grenoble Alpes, Grenoble, France
| | | | | | | | | | | | - Christos Chouaïd
- Service de Pneumologie, CHI Créteil, UPEC, Créteil, France
- Inserm U955, UPEC, IMRB, équipe CEpiA, Créteil, France
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Cotté FE, Voillot P, Bennett B, Falissard B, Tzourio C, Foulquié P, Gaudin AF, Lemasson H, Grumberg V, McDonald L, Faviez C, Schück S. Exploring the Health-Related Quality of Life of Patients Treated With Immune Checkpoint Inhibitors: Social Media Study. J Med Internet Res 2020; 22:e19694. [PMID: 32915159 PMCID: PMC7519426 DOI: 10.2196/19694] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/10/2020] [Accepted: 07/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are increasingly used to treat several types of tumors. Impact of this emerging therapy on patients' health-related quality of life (HRQoL) is usually collected in clinical trials through standard questionnaires. However, this might not fully reflect HRQoL of patients under real-world conditions. In parallel, users' narratives from social media represent a potential new source of research concerning HRQoL. OBJECTIVE The aim of this study is to assess and compare coverage of ICI-treated patients' HRQoL domains and subdomains in standard questionnaires from clinical trials and in real-world setting from social media posts. METHODS A retrospective study was carried out by collecting social media posts in French language written by internet users mentioning their experiences with ICIs between January 2011 and August 2018. Automatic and manual extractions were implemented to create a corpus where domains and subdomains of HRQoL were classified. These annotations were compared with domains covered by 2 standard HRQoL questionnaires, the EORTC QLQ-C30 and the FACT-G. RESULTS We identified 150 users who described their own experience with ICI (89/150, 59.3%) or that of their relative (61/150, 40.7%), with 137 users (91.3%) reporting at least one HRQoL domain in their social media posts. A total of 8 domains and 42 subdomains of HRQoL were identified: Global health (1 subdomain; 115 patients), Symptoms (13; 76), Emotional state (10; 49), Role (7; 22), Physical activity (4; 13), Professional situation (3; 9), Cognitive state (2; 2), and Social state (2; 2). The QLQ-C30 showed a wider global coverage of social media HRQoL subdomains than the FACT-G, 45% (19/42) and 29% (12/42), respectively. For both QLQ-C30 and FACT-G questionnaires, coverage rates were particularly suboptimal for Symptoms (68/123, 55.3% and 72/123, 58.5%, respectively), Emotional state (7/49, 14% and 24/49, 49%, respectively), and Role (17/22, 77% and 15/22, 68%, respectively). CONCLUSIONS Many patients with cancer are using social media to share their experiences with immunotherapy. Collecting and analyzing their spontaneous narratives are helpful to capture and understand their HRQoL in real-world setting. New measures of HRQoL are needed to provide more in-depth evaluation of Symptoms, Emotional state, and Role among patients with cancer treated with immunotherapy.
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Affiliation(s)
| | | | | | - Bruno Falissard
- Paris-Sud University, Paris, France.,Paris-Descartes Universitiy, Paris, France.,AP-HP, Paris, France.,INSERM U1178, Paris, France
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Chouaid C, Levra MG, Corre R, Calvet C, Gaudin AF, Grumberg V, Jolivel R, Jouaneton B, Assié JB, Cotté FE. Nivolumab treatment in advanced non-small cell lung cancer (aNSCLC): A French nationwide retrospective cohort (UNIVOC Study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Levra MG, Cotté F, Corre R, Calvet C, Jouaneton B, Jolivel R, Gaudin A, Grumberg V, Assié J, Chouaid C. MA07.06 Immunotherapy Re-Challenge After Nivolumab Treatment in Advanced Non-Small Cell Lung Cancer in French Real-World Setting. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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