Introduction: Health-related quality of life (HRQOL) has been reported in clinical trials of pembrolizumab and avelumab treatment of locally advanced or metastatic urothelial carcinoma. However, few studies have investigated the effect of immune checkpoint inhibitors (ICIs) on HRQOL in patients with urothelial carcinoma in a real-world setting. Methods: We included 44 patients with advanced urothelial cancer who were treated with pembrolizumab or avelumab from January 2018 to November 2023. When patients visited our hospital for treatment, we evaluated their HRQOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care. We retrospectively reviewed the interview sheets. Results: The median time to deterioration in global health status was 19.1 weeks. The mean scores of emotional functioning were improved in weeks 18 and 36 compared with baseline. The mean scores for fatigue and appetite loss were also improved in weeks 18 and 36. Conclusion: ICI treatment for advanced urothelial carcinoma did not worsen HRQOL over time in a real-world setting. Tolerability of ICIs for advanced urothelial carcinoma appears good in those who received long-term treatment.

Immune checkpoint inhibitors (ICIs) are a type of immunotherapy which were shown to be associated with longer survival compared with conventional chemotherapy and approved as second-line therapy after platinum-based chemotherapy. Few studies have investigated the effect of ICIs on health-related quality of life (HRQOL) in patients with urothelial carcinoma in a real-world setting. In the present study, we included 44 patients with advanced urothelial cancer who were treated with ICIs and evaluated their HRQOL using the authorized questionnaire from European Organization for Research and Treatment of Cancer. Linear transformation was applied to standardize raw scores in the questionnaire. There were minimal changes in the mean scores of most items in the questionnaire. The mean scores of emotional status, fatigue, and appetite loss were improved in weeks 18 and 36 compared with baseline. Our study indicated that ICIs for advanced urothelial carcinoma did not worsen HRQOL over time in a real-world setting.

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