Health-related quality of life (QoL) in patients with advanced melanoma receiving immunotherapies in real-world clinical practice settings

Richard W. Joseph, Frank Xiaoqing Liu, Alicia C. Shillington, Cynthia P. Macahilig, Scott J. Diede, Vaidehi Dave, Qing Harshaw, Todd L. Saretsky, Alan Simon Pickard

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Pembrolizumab (PEMBRO) and ipilimumab + nivolumab (IPI + NIVO) are approved advanced melanoma (AM) immunotherapies. To address limited health-related quality of life (QoL) real-world evidence with immunotherapies in AM, we compared QoL in AM patients receiving either treatment in clinical practice. Methods: A prospective US observational study enrolled adult AM patients initiating first-line PEMBRO or IPI + NIVO between June 2017 and March 2018. Endpoints included the QLQ-C30 global health score (GHS) and EuroQol visual analog scale (EQ-VAS) scores. Mean changes were compared using repeated measures mixed-effects models and are presented covariate adjusted. Results: 225 PEMBRO and 187 IPI + NIVO patients were enrolled. From baseline through week 24, PEMBRO was associated with 3.2 mean GHS score increase (95% CI 0.5, 5.9; p =.02), while no change was observed with IPI + NIVO; 0.2 (95% CI − 2.6, 3.0; p = 0.87). Among objective treatment-responders, GHS scores associated with PEMBRO increased 6.0 (95% CI 3.1, 8.8; p <.0001); IPI + NIVO patients increased 3.8 (95% CI 0.8, 6.9; p =.01). In treatment non-responders, IPI + NIVO was associated with GHS/QoL deterioration of − 3.7 (95% CI − 6.8, − 0.6; p =.02), PEMBRO non-responders demonstrated no change; 0.7 (95% CI − 2.3, 3.7; p = 0.6). Between treatments, PEMBRO patients increased 2.6 greater in EQ-VAS (95% CI 0.6, 4.5; p =.01) vs IPI + NIVO at 24 weeks. Conclusions: PEMBRO was associated with better 24-week QoL compared to IPI + NIVO in actual clinical practice settings. Real-world data has known limitations, but with further confirmation these results may have implications for treatment selection.

Original languageEnglish (US)
Pages (from-to)2651-2660
Number of pages10
JournalQuality of Life Research
Issue number10
StatePublished - Oct 1 2020


  • Immunotherapy
  • Melanoma
  • Metastatic
  • Patient reported outcomes
  • Quality of life

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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