Journal article
Immune Checkpoint Inhibitor Use Near the End of Life Is Associated With Poor Performance Status, Lower Hospice Enrollment, and Dying in the Hospital
American journal of hospice & palliative medicine, Vol.37(3), pp.179-184
03/2020
DOI: 10.1177/1049909119862785
PMID: 31307205
Abstract
Immune checkpoint inhibitors have changed the landscape of cancer care by increasing progression-free and overall survival in some patients with cancer. We evaluated use and variables contributing to immune checkpoint inhibitor treatment near the end of life.
We studied 157 patients who received immune checkpoint inhibitors and died between January 2015 and December 2018. All patients had a palliative care consult any time between starting an immune checkpoint inhibitor and death. Univariate and multivariate models were used to examine variables related to immune checkpoint inhibitor use near the end of life.
Among 157 patients studied, 42 (27%) received a dose of immune checkpoint inhibitor in the last 30 days of life. Those who received treatment in the last 30 days of life had lower hospice enrollment (19 [45%] vs 78 [69%],
= .007) and higher rates of dying in the hospital (23 [56%] vs 33 [29%],
= .002). The percentage of patients with Eastern Cooperative Oncology Group (ECOG) ≥3 at the time of last immune checkpoint inhibitor dose was higher in the group that received immune checkpoint inhibitor treatment in the last 30 days of life (11 [26%] vs 9 [8%],
= .003). Lack of traditional chemotherapy after immune checkpoint inhibitor, ECOG ≥3, and lack of hospice enrollment were independently associated with receiving immune checkpoint inhibitor in the last 30 days of life.
Immune checkpoint inhibitor use in the last 30 days of life is common and associated with poor performance status, lower hospice enrollment, and dying in the hospital.
Details
- Title: Subtitle
- Immune Checkpoint Inhibitor Use Near the End of Life Is Associated With Poor Performance Status, Lower Hospice Enrollment, and Dying in the Hospital
- Creators
- Chad Glisch - Department of Medicine, Supportive and Palliative Care Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USAYuya Hagiwara - Department of Medicine, Supportive and Palliative Care Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USAStephanie Gilbertson-White - College of Nursing, University of Iowa, Iowa City, IA, USAYubo Gao - Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USALaurel Lyckholm - Division of Hematology, Oncology, Blood and Marrow Transplantation, Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
- Resource Type
- Journal article
- Publication Details
- American journal of hospice & palliative medicine, Vol.37(3), pp.179-184
- DOI
- 10.1177/1049909119862785
- PMID
- 31307205
- ISSN
- 1049-9091
- eISSN
- 1938-2715
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Nursing; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094516702771
Metrics
13 Record Views