Evaluation of health-related quality of life and symptoms in patients with advanced non-squamous non-small cell lung cancer treated with nivolumab or docetaxel in CheckMate 057

Martin Reck, Julie Brahmer, Bryan Bennett, Fiona Taylor, John R. Penrod, Michael DeRosa, Homa Dastani, David R. Spigel, Richard J. Gralla

Research output: Contribution to journalArticle

8 Scopus citations


Background: Nivolumab, a programmed death-1 inhibitor, prolonged overall survival and had a favourable safety profile versus docetaxel in previously treated patients with advanced non-squamous non-small cell lung cancer (NSCLC) in the phase III CheckMate 057 trial. Aim: To evaluate health-related quality of life (HRQoL) using patient-reported outcomes. Methods: Disease-related symptoms and general health status were assessed using two validated patient-reported instruments, the Lung Cancer Symptom Scale (LCSS) and the European Quality of Life Five Dimensions (EQ-5D), respectively. The proportion of patients with disease-related symptom improvement at 12 weeks on the LCSS average symptom burden index (ASBI) was a secondary end-point. LCSS 3-item global index (3-IGI), EQ-5D utility index and EQ-5D visual analogue scale (VAS) scores were also determined. Mixed-effects model repeated measures (MMRM) and time to first deterioration analyses assessed longitudinal changes. Results: Mean baseline LCSS ASBI scores were similar in both arms. By week 12, rates of disease-related improvement (95% confidence interval) were similar between nivolumab (17.8% [13.6–22.7]) and docetaxel (19.7% [15.2–24.7]); however, numerical differences in LCSS ASBI mean change from baseline favoured nivolumab. Subsequently, LCSS ASBI scores improved with nivolumab and worsened with docetaxel, with statistically significant between-arm differences at weeks 12, 24, 30 and 42. HRQoL improvements with nivolumab versus docetaxel were also supported by the LCSS 3-IGI, EQ-5D VAS and MMRM analysis. Time to first HRQoL deterioration was longer with nivolumab than with docetaxel. Conclusion: Nivolumab improved disease-related symptoms and overall health status versus docetaxel for second-line treatment of advanced non-squamous NSCLC. Clinical trial registration: NCT01673867.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalEuropean Journal of Cancer
StatePublished - Oct 2018



  • Antineoplastic agents
  • Carcinoma
  • Docetaxel
  • Lung neoplasms
  • Nivolumab
  • Non-small cell lung
  • Quality of life
  • Surveys and questionnaires

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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