Patient-reported health-related quality of life (QOL) is an important part of a cancer patient's treatment plan and has been linked to overall cancer survival. We aimed to identify the impact of QOL and potential genetic factors on five-year lung cancer survival using a lung cancer patient cohort from MD Anderson Cancer Center. QOL data was obtained from the SF-12 questionnaire. Patient responses were used to calculate Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, with a lower score indicating a worse QOL. Mean baseline QOL scores were calculated for demographic factors in 7,135 patients, and individuals with a college degree (PCS = 42.0, compared to less than a high school degree PCS = 35.1, P<0.0001), current alcohol drinkers (PCS = 42.0, compared to never drinkers PCS = 37.3, P<0.0001), and those with no significant medical history (PCS = 40.8, compared to a significant history PCS = 38.4, P<0.0001) reported an improved PCS. Individuals greater than 70 years old (MCS = 47.8, compared to those less than 50 MCS = 45.2, P<0.0001), with a college degree (MCS = 48.0, compared to less than a high school degree MCS = 45.2, P<0.0001), Asian Pacific Islanders (MCS = 48.5, compared to whites MCS = 46.3, P = 0.033), and current alcohol drinkers (MCS = 47.4, compared to never drinkers MCS = 45.9, P<0.0001) reported a better MCS. We then analyzed the association between baseline QOL and lung cancer survival using survival data obtained from MD Anderson Tumor Registry. A PCS or MCS score less than 50 was associated with an increased risk of five-year mortality (HR = 1.20, 95% CI: 1.08-1.33, P = 0.001; HR = 1.13, 95%CI: 1.03-1.24, P = 0.008, respectively) and there was a significant difference between median survival time (MST) (PCS≥50 MST = 30.42 months, PCS<50 MST = 20.70 months, Plog-rank<0.0001) (MCS≥50 MST = 26.12 months, MCS<50 MST = 20.17 months, Plog-rank<0.0001). Finally, using a subset of the study population (N = 588), we completed a preliminary analysis of 218 single nucleotide polymorphisms (SNPs) in the p38 MAPK signaling pathway, activated in response to cellular and environmental stress, as a potential genetic determinant of QOL and five-year lung cancer survival. Using a score of 50 as the cut-off, twenty-five SNPs were associated with PCS, twenty-three SNPs were associated with MCS, and 28 SNPs were associated with five-year lung cancer survival (P<0.05). Individuals with at least one variant allele of rs2715815 in MAP2K6 showed a decreased risk of poor PCS and MCS score (OR = 0.49, 95% CI = 0.26-0.90, P = 0.022; OR = 0.41, 95% CI = 0.22-0.76, P = 0.005, respectively). At least one variant allele of FASLG: rs5030772 was associated with a decreased risk of poor MCS score (OR = 0.51, 95% CI = 0.27-0.96, P = 0.038) and a decreased risk of lung cancer death (HR = 0.68, 95% CI = 0.46-1.00, P = 0.049). These findings suggest that baseline QOL in lung cancer patients as well as genetic determinants may impact lung cancer survival.
Citation Format: Jeanne A. Pierzynski, Michelle A. Hildebrandt, Yuanqing Ye, Jack A. Roth, Xifeng Wu. Baseline quality of life and genetic determinants and the impact on five-year lung cancer survival. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3707. doi:10.1158/1538-7445.AM2015-3707