PMID- 37563020 OWN - NLM STAT- MEDLINE DCOM- 20240304 LR - 20240304 IS - 0929-6646 (Print) IS - 0929-6646 (Linking) VI - 123 IP - 2 DP - 2024 Feb TI - The impact of comorbidities, neutrophil-to-lymphocyte ratio, and drug toxicities on quality of life in lung cancer patients receiving EGFR-TKI therapy. PG - 198-207 LID - S0929-6646(23)00291-7 [pii] LID - 10.1016/j.jfma.2023.07.017 [doi] AB - 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-naive 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. CI - Copyright (c) 2023. Published by Elsevier B.V. FAU - Chen, Jung-Yueh AU - Chen JY AD - School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Internal Medicine, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan. FAU - Liang, Sheng-Kai AU - Liang SK AD - Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan; Department of Internal Medicine, National Taiwan University Cancer Center, Taiwan. FAU - Chuang, Tzu-Yi AU - Chuang TY AD - Division of Chest Medicine and Critical Care, Department of Internal Medicine, China Medical University Hsinchu Hospital, Hsinchu, Taiwan. FAU - Chu, Chia-Yu AU - Chu CY AD - Department of Dermatology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. FAU - Tu, Chia-Hung AU - Tu CH AD - Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. FAU - Yeh, Yu-Jo AU - Yeh YJ AD - Joint Commission of Taiwan, New Taipei City, Taiwan. FAU - Wei, Yu-Feng AU - Wei YF AD - School of Medicine for International Students, College of Medicine, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan; Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan. FAU - Chen, Kuan-Yu AU - Chen KY AD - Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. Electronic address: tuff.chen@msa.hinet.net. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20230809 PL - Singapore TA - J Formos Med Assoc JT - Journal of the Formosan Medical Association = Taiwan yi zhi JID - 9214933 RN - EC 2.7.10.1 (ErbB Receptors) RN - EC 2.7.10.1 (EGFR protein, human) SB - IM MH - Humans MH - *Lung Neoplasms/drug therapy MH - *Carcinoma, Non-Small-Cell Lung/drug therapy MH - Quality of Life MH - Anorexia MH - Neutrophils MH - Pain MH - Pruritus MH - Diarrhea MH - Lymphocytes MH - *Drug-Related Side Effects and Adverse Reactions/epidemiology MH - ErbB Receptors/genetics OTO - NOTNLM OT - Adverse events OT - Comorbidity OT - Epidermal growth factor receptor tyrosine kinase inhibitor OT - Neutrophil-to-lymphocyte ratio OT - Non-small cell lung cancer OT - Quality of life COIS- 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. EDAT- 2023/08/11 00:41 MHDA- 2024/03/04 06:50 CRDT- 2023/08/10 21:58 PHST- 2023/04/12 00:00 [received] PHST- 2023/07/11 00:00 [revised] PHST- 2023/07/27 00:00 [accepted] PHST- 2024/03/04 06:50 [medline] PHST- 2023/08/11 00:41 [pubmed] PHST- 2023/08/10 21:58 [entrez] AID - S0929-6646(23)00291-7 [pii] AID - 10.1016/j.jfma.2023.07.017 [doi] PST - ppublish SO - J Formos Med Assoc. 2024 Feb;123(2):198-207. doi: 10.1016/j.jfma.2023.07.017. Epub 2023 Aug 9.