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Systemic anticancer therapy at the end of life—changes in usage pattern in the immunotherapy era

Published

October 2022

Citation

Canavan ME, Wang X, Ascha MS, et al. Systemic Anticancer Therapy at the End of Life—Changes in Usage Pattern in the Immunotherapy Era. JAMA Oncol. 2022. http://doi.org/10.1001/jamaoncol.2022.4666

Our summary

Use of systematic anticancer therapy (SACT) at end of life (EOL) is connected to delayed goals-of-care conversations, late hospice enrollment, higher costs and may also adversely affect the quality of care the patient receives. Following the approvals of multiple new immunotherapies, the SACT landscape has drastically changed over the last 10 years. Previous studies were limited to outdated estimates, single cancer type or payer group. Using nationwide contemporary real-world data, researchers from Yale Cancer Center and Flatiron sought to analyze patterns in SACT near EOL across all cancer deaths to understand changes in use of cytotoxic chemotherapy and targeted therapies.

Why this matters

This study is the first to identify a great replacement phenomenon, substituting immunotherapy for chemotherapy, which may interfere with achieving the goal of earlier palliative care integration or reduction in acute care use.

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