Data Sheet 1_Dynamics trajectory of patient-reported quality of life and its associated risk factors among hepatocellular carcinoma patients receiving immune checkpoint inhibitors: a prospective cohort study.docx

ObjectiveWe aimed to characterize quality of life (QOL) trajectories among patients
with intermediate and advanced hepatocellular carcinoma patients treated with immunotherapy.
MethodsBarcelona Clinic Liver Cancer (BCLC) stage B-C HCC patients receiving
immunotherapy at Guangxi Medical University Cancer Hospital were included. Trajectories of QOL,
assessed using the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire,
were identified through iterative estimations of group-based trajectory models. Associations with trajectory group membership were analyzed using multivariable multinomial logistic regression.
ResultsThree trajectory groups were identified (n=156): excellent (35.3%), poor
(43.6%), and deteriorating (21.1%) QOL. The deteriorating trajectory group reported a mean QOL score
of 124.79 (95% CI, 116.58–133.00), but then declined significantly at month-2 (estimated QOL
score 98.67 [95% CI, 84.33–113.00]), and the lowest mean score is reached at month-6 (estimated QOL score 16.58 [95% CI, 0–46.07]). Factors associated with membership to the deteriorating group included no drinking (odds ratio [OR] vs yes [95% CI], 3.70 [1.28–11.11]), no received radiotherapy (OR vs yes [95% CI], 8.33 [1.41–50.00]), diabetes (OR vs no [95% CI], 6.83 [1.57–29.73]), and extrahepatic metastasis (OR vs no [95% CI], 3.08 [1.07–8.87]). Factors associated with membership to the poor group also included body mass index ≤24.0 kg/m2 (OR vs no [95% CI], 4.49 [1.65–12.22]).
ConclusionsThis latent-class analysis identified a high-risk cluster of patients with
severe, persistent post-immunotherapy QOL deterioration. Screening relevant patient-level
characteristics may inform tailored interventions to mitigate the detrimental impact of
immunotherapy and preserve QOL.