OBJECTIVES: NSCLC, particularly at advanced stages, causes significant symptom burden. This study aimed to gain insight into patients’ experience with adv/met NSCLC and understand what constitutes meaningful change in cancer symptoms using Patient Global Impression of Severity (PGIS) and Change (PGIC) instruments.

METHODS: Semi-structured, qualitative, 45–60-minute open-ended question interviews were conducted by telephone/virtual platform with US patients with adv/met NSCLC. Patients discussed their most bothersome NSCLC symptoms and impacts, and rated their ‘current’ (last 7 days) and ‘previous’ (6–12 months ago) symptoms using PGIS and PGIC, which were also debriefed.

RESULTS: Nineteen patients (aged 28–71; 95% female) with Stage IV NSCLC were interviewed. Most were receiving targeted therapy (63%) and were diagnosed with adv/met NSCLC >12 months prior (79%). All patients understood well the PGIS/PGIC items/response options; however, some had difficulty distinguishing cancer symptoms from treatment side-effects when conducting evaluations. The most commonly reported symptoms included shortness of breath/difficulty breathing, fatigue, cough and pain. Most patients (14/19) rated their ‘current’ cancer symptoms as ‘mild’ or ‘moderate’ on the 5-point PGIS. Nearly all patients deemed a 1-point PGIS improvement or worsening to be meaningful (14/17 and 16/18 patients, respectively; 2 patients reported ‘no current symptoms’, 1 reported ‘very severe’ symptoms and therefore could not be included in the improvement/worsening assessments). Comparing ‘current’ versus ‘previous’ symptoms on the 5-point PGIC, 6 patients were ‘a little worse’, 5 were ‘much better’. For 10/18 patients, ‘no change’ was considered meaningful (positively or negatively). A 1-point change (‘a little better/worse’) in PGIC was deemed meaningful by 17/19 patients.

CONCLUSIONS: Cancer symptoms PGIS and PGIC were clear and provided valuable insights into symptoms of adv/met NSCLC. A 1-point meaningful change threshold in PGIS/PGIC was identified as an anchor for patient-reported outcomes.