Patients With Metastatic Cancer Increasingly Receive Immunotherapy at End of Life

Patients with metastatic cancer are increasingly receiving immunotherapy at the end of their lives, according to a study published in JAMA Oncology.

The study included 242,371 patients with metastatic melanoma, non-small cell lung cancer (NSCLC), or kidney cancer who were enrolled in the National Cancer Database.

Researchers found that the use of immunotherapy increased over time for all 3 cancers studied, and the proportion of patients who received end-of-life immunotherapy increased as well.

In the melanoma cohort (n=20,415), 41% of patients received immunotherapy and lived longer than 1 month after starting it, but 3% of patients received immunotherapy at the end of life. The proportion of patients who received end-of-life immunotherapy increased from 0.8% in 2012 to 4.3% in 2019.

In the NSCLC cohort (n=197,331), 26% of patients received immunotherapy before the end of life, and 3% received it at the end of life. The proportion of patients who received end-of-life immunotherapy increased from 0.9% in 2016 to 3.2% in 2019.

In the kidney cancer cohort (n=24,625), 26% of patients received immunotherapy before the end of life, and 2% received it at the end of life. The proportion of patients who received end-of-life immunotherapy increased from 0.5% in 2016 to 2.6% in 2019.

“In 2019, these end-of-life–initiated treatments represented 7.3% of all immunotherapy treatments,” the researchers noted.

They found that treatment at an academic or high-volume center was associated with significantly lower odds of starting immunotherapy at the end of life, when compared to treatment at a nonacademic center (odds ratio [OR], 0.69; 95% CI, 0.65-0.74; P <.001) or very low-volume center (OR, 0.70; 95% CI, 0.65-0.76; P <.001).

On the other hand, metastases in at least 3 solid organs was associated with higher odds of starting immunotherapy at the end of life (OR, 3.84; 95% CI, 3.11-4.73; P <.001).

The researchers concluded that these findings can “offer insights into national prescribing patterns and serve as a harbinger for shifts in the clinical approach to patients with advanced cancer.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Cancer Therapy Advisor