Importance of patient related outcomes in diagnosing fatigue related to immunotherapy treatment in patients with lung cancer: A real life study.

Abstract

e14709 Background: Lung cancer is a common cancer with a dismal prognosis that was improved with treatment with check-point inhibitors (CPI). Fatigue is the most frequent adverse event of CPI, often undervalued by physicians. Patient report outcomes may be a key to overcome underdiagnose of fatigue. Methods: The aim of this study is to identify whether the assessment Non-Small Cell Lung Cancer (NSCLC) patients report when answering the BFI questionnaire of fatigue is consistent with the one recorded by the clinical team at the pneumology consultation the during treatment with immunotherapy in monotherapy or in combination with chemotherapy. A prospective observational study was carried out during 8 months. The research was conducted through the collection of medical records from the patients clinical files and the application of the Brief Fatigue Inventory questionnaire before each one of the 4 treatment cycles. This questionnaire was validated and linguistically translated into Portuguese and assesses the severity and functional impact of fatigue in cancer patients. A 95% confidence interval was considered. Results: The 31 patients, 26 male (84%) and 5 female (16%) with a mean age of 68.5 years. The mean value of the BFI score before the first treatment, as well as in the following 3 evaluations, was higher for the participants who presented symptoms of asthenia/tiredness/fatigue recorded in the clinical files at the consultation and lower for those who did not. However, the differences were not statistically significant (pre 1st treatment - p=0.299, pre 2nd treatment - p=0.125, pre 3rd treatment - p=0.103 and pre 4th treatment - p=0.954). By comparing the BFI score with medical records, we found that fatigue remained underreported at the consultation in different assessment times (71% of sample participants were not identified as having fatigue at the 1st assessment time; 60% at the pre 2nd treatment visit; 54% at the pre 3rd treatment visit and 40% at the pre 4th treatment visit). Conclusions: In the present study, the BFI questionnaire allowed us to identify and stratify fatigue, showing greater sensitivity when compared to the medical records of the consultation alone.