565eP Gender differences in quality of life, mental health, and survivorship experiences following lung cancer: A systematic literature review

Abstract

Background: We aimed to expand understanding of gender-specific patient experiences across the lung cancer (LC) journey, including quality of life (QoL), mental health, the impact of adverse events (AEs) on well-being, and the long-term implications for survivorship. Method(s): A systematic literature review was conducted using a PICOS framework to identify publications reporting on gender differences in patients with LC. Embase, MEDLINE, MEDLINE In-Process, and Cochrane databases were searched for English-language publications (Jan 2004 to Feb 2024). Excluded studies did not report on the population, study design, outcomes, language, and/or timeframe outlined in the framework. Data from articles providing adjusted estimates of gender comparison using regression analysis were reported. Result(s): Initial searches identified 5,166 unique publications reporting on the continuum of care and 689 on survivorship, of which 1,318 and 296 were reviewed in full, respectively. The final review included publications reporting on gender differences in mental health and QoL (n=30), AEs (n=6), and survivorship (n=7), covering approximately 1.7 million patients. In 5/6 studies, women reported lower QoL scores following LC treatment compared with men, including lower emotional well-being (3/4 studies, beta: -1.49 to -1.83) and worse physical QoL (2/2 studies, beta: -2.44 to -6.44). 9/10 studies showed a significantly higher incidence of depression (OR: 1.44-2.11) and 3/4 studies reported higher rates of anxiety for women vs men. Three studies found that women were more likely than men to use psychosocial services and receive supportive end-of-life care. Six studies assessed the incidence of AEs following LC treatment; most found that women had significantly higher risk of experiencing certain AEs compared with men (e.g. fatigue, appetite loss, diarrhea), potentially associated with worse physical and emotional QoL, although men reported more cardiac-related toxicities and acute kidney injury. Conclusion(s): Women with LC report worse QoL, greater emotional burden, and higher rates of AEs compared with men. These disparities highlight the need for gender-informed care approaches with a focus on gender-tailored interventions. Editorial acknowledgement: Medical writing support, under the direction of the authors, was provided by Taylor Stepien, PhD (Chicago, IL, USA) of Ashfield MedComms, an Inizio company, and funded by AstraZeneca. Legal entity responsible for the study: AstraZeneca. Funding(s): AstraZeneca. Disclosure: N. Florez: Financial Interests, Personal, Advisory Board: Johnson & Johnson, Sanofi, Pfizer, Mirati, Bristol Myers Squibb, Merck, Regeneron, Takeda, Lilly, Daiichi Sankyo, EMD Serono, Novartis, Jazz Pharmaceuticals, Genentech-Roche, Nuvalent, Nuvation Bio, Catalyst Pharmaceuticals, Caris, and AstraZeneca; Financial Interests, Personal and Institutional, Funding, Research Funding: Genentech, AstraZeneca, Daiichi-Sankyo Foundation; Other, Personal, Member of Board of Directors: International Association for the Study of Lung Cancer; Financial Interests, Personal, Principal Investigator: Nuvation Bio, Boehringer Ingelheim, Johnson and Johnson, AstraZeneca, Genentech; Financial Interests, Personal and Institutional, Research Grant: Genentech, AstraZeneca, and Daiichi-Sankyo Foundation; Financial Interests, Personal, Speaker's Bureau: MJH Sciencies, CCO, Onclive, Curius Science, Ideology and Peer View, Dava Oncology. C. Pompili: Financial Interests, Personal, Advisory Board: AstraZeneca, Roche, Johnson & Johnson; Financial Interests, Personal, Invited Speaker: AstraZeneca, Johnson & Johnson, BMS. C. Aggarwal: Financial Interests, Personal, Advisory Board: Nuvation, Nuvalent, Natera, Merck, Pfizer, Thermo Fisher, Candel Therapeutics, AstraZeneca; Financial Interests, Personal, Advisory Role: AstraZeneca, Daiichi Sankyo/AstraZeneca, Pfizer, Gilead Sciences, Novocure, AbbVie; Financial Interests, Institutional, Research Grant: Merck Sharp & Dohme Loxo @ Lilly, Genmab, AstraZeneca/Medimmune, Daiichi Sankyo/AstraZeneca, Candel Therapeutics; Financial Interests, Personal, Speaker's Bureau, An Immediate Family Member: AstraZeneca. J.R. Brahmer: Financial Interests, Personal, Advisory Board: AstraZeneca, Amgen, Bristol Myers Squibb International, summit therapeutics, Merck, GSK; Financial Interests, Institutional, Invited Speaker: AstraZeneca; Financial Interests, Institutional, Research Grant: AstraZeneca; Non-Financial Interests, Personal, Leadership Role, Immunotherapy Toxicity Guideline CoChair: NCCN; Non-Financial Interests, Personal, Member: ASCO, AACR; Non-Financial Interests, Personal, Leadership Role, Guideline Co chair: SITC; Non-Financial Interests, Personal, Leadership Role, Thoracic Cancer Committee Chair: ECOG-ACRIN. E. Felip: Financial Interests, Personal, Advisory Board: AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Genentech / Roche, GSK, Iteos Therapeutics, Janssen / Johnson & Johnson, Merck Sharp & Dohme, Pierre Fabre, Pfizer, PharmaMar, Seagen, Regeneron, Tubuli; Financial Interests, Personal, Invited Speaker: Amgen, Daiichi Sankyo, Eli Lilly, Roche / Genentech, Gilead, Janssen /Johnson & Johnson, Medical Trends, Medscape, Merck Sharp & Dohme, Peervoice, Pfizer; Financial Interests, Personal, Other, Travel, Accommodations, Expenses: AstraZeneca, Johnson & Johnson, Roche, Amgen; Other, Personal, Other, Independent Member of the Board: Grifols. P. Garrido Lopez: Financial Interests, Personal, Advisory Board: AbbVie, Amgen, AstraZeneca, Bayer, BeiGene, Boehringer Ingelheim, Bristol Myers Squibb International, Daiichi Sankyo, GSK, Johnson and Johnson, MSD, Novartis, PharmaMar, Pierre Fabre, Regeneron, Roche and Sanofi; Financial Interests, Personal, Invited Speaker: Lilly, Regeneron, MSD. N. Karim: Financial Interests, Personal, Advisory Board: Bristol-Myers Squibb, Amgen, AstraZeneca, Merck, Jazz, Merck, Pfizer, G1 Therapeutics, Novocure, Immunocore, BMS, Immunogen. Regeneron, Sanofi, Nuvation; Financial Interests, Personal, Speaker's Bureau: Regeneron. D. Molena: Financial Interests, Personal, Advisory Board: AstraZeneca, Johnson & Johnson, Proteomics; Financial Interests, Personal, Advisory Role: Boston Scientific, AstraZeneca, J&J, Proteomics; Financial Interests, Personal, Invited Speaker: AstraZeneca, Medela, Johnson & Johnson, Bioscend; Non-Financial Interests, Personal, Leadership Role: AATS, ISDE, STSA, SSAT; Non-Financial Interests, Personal, Member of Board of Directors: AATS, ISDE, STSA, SSAT. J. Naidoo: Financial Interests, Personal, Advisory Board: AstraZeneca, Bristol Myers Squibb, RocheGenentech, Amgen,Summit Therapeutics, Arcus Biosciences.Gilead,Zymeworks, GSK Pharmaceuticals, Bayer, Regeneron, Takead, Pfizer, Elevation Oncology,AbbVie, Revolution Medicine, Dailchi Sankyo. S. Peters: Financial Interests, Personal, Advisory Board: AbbVie, Amgen, Arcus, AstraZeneca, Bayer, Beigene, BioNTech, BerGenBio, Bicycle Therapeutics, Biocartis, BioInvent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F-Star, Foundation Medicine; Financial Interests, Personal, Advisory Role: AbbVie, Amgen, Arcus, AstraZeneca, Bayer, Beigene, BioNTech, BerGenBio, Bicycle Therapeutics, Biocartis, BioInvent, Blueprint Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F-Star, Foundation Medicine; Financial Interests, Personal, Invited Speaker: AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, Foundation Medicine, GSK, Illumina, Ipsen, Merck Sharp and Dohme, Novartis, Pfizer, Roche/Genentech, Sanofi, Takeda.; Non-Financial Interests, Personal, Member: ASCO, ESMO, AACR, IASLC, SAMO, SSOM, & Many scientific societies, no conflict.; Financial Interests, Institutional, Research Grant: Amgen, Arcus, AstraZeneca, Beigene, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GSK, iTeos, Merck Sharp and Dohme, Mirati, Pharma Mar, Pfizer, Promontory Therapeutics, Roche/Genentech.; Financial Interests, Institutional, Principal Investigator: Amgen, Arcus, AstraZeneca, Beigene, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GSK, iTeos, Merck Sharp and Dohme, Mirati, Pharma Mar, Pfizer, Promontory Therapeutics, Roche/Genentech.. E. Shum: Financial Interests, Personal, Advisory Board: AstraZeneca, Genentech, Boehringer Ingelheim, Bristol Myers Squibb, Johnson and Johnson, Nuvalent, Regeneron. H. Wakelee: Financial Interests, Personal, Advisory Board: IOBiotech, OncoC4, Beigene (BeOne), GSK, AstraZeneca; Non-Financial Interests, Personal, Advisory Role: BMS, Genentech/Roche; Merck; AstraZeneca; Financial Interests, Institutional, Research Grant: AstraZeneca; Bayer; BMS; Genentech/Roche; Merck; Pfizer (SeaGen); Xcovery, Gilead; Financial Interests, Personal, Other, Travel, Accommodations, and Expenses: Chugai. J. Chaieb, R. Shenolikar: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. All other authors have declared no conflicts of interest. Copyright © 2025