Impact of TTFields therapy on global and functional health-related quality of life (HRQoL) in metastatic non-small cell lung cancer (mNSCLC) from the pivotal LUNAR study

Tumor Treating Fields (TTFields) are electric fields that disrupt processes critical for cancer cell survival. The randomized, pivotal LUNAR study met its primary endpoint, demonstrating significantly improved OS with TTFields/standard of care (SOC; investigator’s choice immune checkpoint inhibitor or docetaxel) vs SOC in mNSCLC following platinum failure without added systemic toxicity. A prior study in glioblastoma showed that adding TTFields therapy to standard chemotherapy did not adversely affect HRQoL. Herein we report global and functional HRQoL from LUNAR. Adults with mNSCLC progressing on/after platinum therapy were randomized 1:1 to TTFields/SOC or SOC. HRQoL was assessed at baseline (BL) and every 6 weeks (to 54 weeks) by the EORTC QLQ-C30 questionnaire. HRQoL outcomes from global health and functional scales are reported here. Scores were calculated as mean change from BL (change of ≥10 points considered clinically relevant). Time to deterioration (TTD) was defined as time from BL to a deterioration of ≥10 points without a subsequent ≥10-point improvement (and no death before the confirmatory assessment). TTD was estimated by Kaplan–Meier plots with medians by Greenwood's formula and comparisons by 2-sided log-rank tests. BL scores were comparable for patients receiving TTFields/SOC (n=134) vs SOC (n=136) in global health status and functioning. Overall, there were no notable differences in change from BL in these scales over time between groups. There were no significant differences between TTFields/SOC vs SOC for median TTD in global health status (4.4 vs 4.0 months, P=0.91), physical functioning (3.2 vs 4.2 months, P=0.58), role functioning (3.0 vs 2.8 months, P=0.59), emotional functioning (6.6 vs 5.7 months, P=0.96), cognitive functioning (3.7 vs 4.4 months, P=0.23), or social functioning (4.0 vs 3.9 months, P=0.66). The HRQoL analysis conducted as part of LUNAR demonstrated that the TTFields device did not adversely affect the quality of life of patients receiving standard second-line therapies, supporting its incorporation into management guidelines for recurrent or progressive, platinum-refractory mNSCLC.