Expert Point of View: Michael Boyer, MBBS, PhD


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“This was a very nice analysis using a well-validated group of instruments with high compliance. And this is something that is one of the bugbears of quality-of-life analyses—compliance to completion of the instruments,” commented invited discussant, Michael Boyer, MBBS, PhD, Chief Clinical Officer and Conjoint Chair of Medical Oncology (Thoracic Oncology), Chris O’Brien Lifehouse, Sydney, Australia.

“The difference in mean [QLQ-C30] score of about 7 is a little less than what is sometimes referred to as a minimal important difference. However, in a randomized trial setting, it probably does tell us that there is an improvement rather than a deterioration in the pembrolizumab [Keytruda] arm,” he said. Additionally, most of the other outcomes assessed favored the immunotherapy.

Of note, the findings are similar to those seen in trials with nivolumab (Opdivo) in the second-line setting, albeit with the use of different assessment instruments, according to Dr. Boyer.


This gives us confidence to use these agents in the first-line setting; not only do they improve overall survival, they at least maintain—and in this case improve—quality of life.
— Michael Boyer, MBBS, PhD

“What these data are telling us is drugs that are effective tend to improve quality of life, provided they do not have significant toxicities or create problems. This gives us confidence to use these agents in the first-line setting in the knowledge that not only do they improve overall survival, they at least maintain—and in this case, in fact, improve—quality of life,” he concluded. “That is important because it lets us know that our patients are benefiting from an improvement in quality of life as well as duration of life.”

Of note, the findings are similar to those seen in trials with nivolumab (Opdivo) in the second-line setting, albeit with the use of different assessment instruments, according to Dr. Boyer.

“What these data are telling us is drugs that are effective tend to improve quality of life, provided they do not have significant toxicities or create problems. This gives us confidence to use these agents in the first-line setting in the knowledge that not only do they improve overall survival, they at least maintain—and in this case, in fact, improve —quality of life,” he concluded. “That is important because it lets us know that our patients are benefiting from an improvement in quality of life as well as duration of life.” ■

Disclosure: Michael Boyer, MBBS, PhD, has received research support from Genentech/Roche, Pfizer, Eli Lilly, Merck Sharpe and Dohme, AstraZeneca, and Clovis.


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