The impact of comorbidities, neutrophil-to-lymphocyte ratio, and drug toxicities on quality of life in lung cancer patients receiving EGFR-TKI therapy.

Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are used as the standard first-line treatment for patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC). However, the impact of comorbidities and treatment toxicities on quality of life (QoL) was seldom investigated.
Objective: We aimed to investigate the association of comorbidities, adverse events (AEs), and QoL in treatment-naïve advanced NSCLC patients receiving EGFR-TKI treatments.
Methods: This multi-center prospective observational study was conducted to evaluate QoL and AEs at baseline, the 2nd, 4th, 12th, and 24th week. Clinical characteristics, comorbidities, and pre-treatment laboratory data were recorded. QoL was assessed by using the summary score of the EORTC QLQ-C30 and the dermatology life quality index. The impact of comorbidities, neutrophil-to-lymphocyte ratio (NLR), and AEs on QoL was analyzed by generalized estimating equations.
Results: A total of 121 patients were enrolled. Diarrhea (p = 0.033), anorexia (p < 0.001), and NLR ≥4 (p = 0.017) were significantly associated with a QoL impairment. Among skin toxicities, acneiform rash (p = 0.002), pruritus (p = 0.002), visual analogue scale for pruritus (≥3 and < 7, p = 0.006; ≥7, p = 0.001) and pain (1-3, p = 0.041) were associated with a QoL impairment. No significant association was found between comorbidities and QoL changes.
Conclusion: Diarrhea, anorexia, skin pain, and pruritus may cause a deterioration in QoL in patients receiving EGFR-TKI therapy. NLR may be a potential predictive factor for QoL impairment. Aggressive management and close monitoring for these clinical factors are crucial to improve QoL.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jung-Yueh Chen has received honoraria for speeches from AstraZeneca, Boehringer Ingelheim, Merck Sharp & Dohme, Eli Lilly, Novartis, Pfizer, Roche, and Chugai Pharmaceutical. Yu-Feng Wei has received honoraria for speeches from Boehringer Ingelheim, Eli Lilly, AstraZeneca, Novartis, Pfizer, Roche, and Chugai Pharmaceutical. Sheng-kai Liang has received honoraria for speeches from Roche, AstraZeneca, Pfizer, Merck Sharp & Dohme, Novartis, and Boehringer Ingelheim. Kuan-Yu Chen has received honoraria for speeches from Pfizer, Novartis, Merck Sharp & Dohme, AstraZeneca, Roche, Boehringer Ingelheim, Daiichi Sankyo, Chugai Pharmaceutical, and Bristol-Myers Squibb, as well as travel/accommodation/meeting expenses from Merck Sharp & Dohme, Chugai Pharmaceutical, and Boehringer Ingelheim. Chia-Yu Chu has received honoraria for speeches from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novartis, Pfizer, Roche. Tzu-Yi Chuang, Chia-Hung Tu, Yu-Jo Yeh declare that they have no competing interests.
(Copyright © 2023. Published by Elsevier B.V.)