LUME-Lung 1 shows QoL, symptoms benefits

By Lynda Williams, Senior medwireNews Reporter

LUME-Lung 1 trial patients’ reports of symptoms and health-related quality of life (HRQoL) support the use of second-line nintedanib for the treatment of advanced non-small-cell lung cancer (NSCLC).

Initial findings from the phase III trial demonstrated that the angiokinase inhibitor plus docetaxel offered significantly better progression-free survival for patients with advanced NSCLC, including subpopulations with adenocarcinoma, than placebo plus docetaxel, explain Silvia Novello (University of Turin, Italy) and co-authors in the European Journal of Cancer.

For the current study, the team used a battery of tests to compare patient-reported outcomes on day 1 of each 21-day treatment cycle, at the end of treatment and at the first follow-up visit for the two treatment groups.

Over 80% of the 655 nintedanib-treated patients and 659 of controls completed the European Organisation for Research and Treatment of Cancer Core QoL Questionnaire and its lung cancer supplement, with 70% doing so at the end of treatment.

Baseline health and QoL were comparable for the nintedanib and placebo groups with relatively good scores and a low burden of lung cancer-specific symptoms, such as cough and pain.

The patient groups also had comparable time to deterioration for cough, pain and dyspnoea, although patients given nintedanib had a significantly shorter time to development of the gastrointestinal symptoms of nausea, vomiting, diarrhoea and decreased appetite.

Similarly, the 322 patients with adenocarcinoma histology given nintedanib alongside docetaxel had a similar time to deterioration of lung cancer symptoms as the 336 given placebo, with a small benefit in global health and QoL with nintedanib detected but this did not reach significance.

Longitudinal analysis for cough, dyspnoea and pain showed a trend towards improvement for the adenocarcinoma patients given nintedanib, with a significant benefit found for having pain, chest pain, arm and shoulder pain.

Small benefits were also identified for emotional, physical and role functioning with nintedanib over placebo, although these were not significant, Novello et al write.

“In conclusion, the significant improvement in [progression-free survival] in the overall population and the significant survival benefit in patients with adenocarcinoma observed with the addition of nintedanib to docetaxel therapy had no detrimental effect on patient-reported QoL relative to the addition of placebo”, the team writes.

“Thus, the combination of nintedanib and docetaxel represents an attractive second-line treatment option for patients with relapsed/refractory NSCLC, and in particular for patients with adenocarcinoma histology.”

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