Those treated at nonacademic or low-volume facilities have higher odds of initiating therapy within one month of death
By Lori Solomon HealthDay Reporter
THURSDAY, Jan. 11, 2024 (HealthDay News) — Initiation of immunotherapy for metastatic cancer at the end of life (EOL) is increasing over time, according to a study published online Jan. 4 in JAMA Oncology.
Daniel M. Kerekes, M.D., from Yale University in New Haven, Connecticut, and colleagues examined patient characteristics, practice patterns, and risk factors concerning EOL-initiated immunotherapy over time. The analysis included data from 242,371 patients with metastatic melanoma, non-small cell lung cancer, or kidney cell carcinoma.
The researchers found that the percentage of patients who received EOL-initiated immunotherapy increased over time for all cancers. In 2019, more than one in 14 immunotherapy treatments were initiated within one month of death. Patients with three or more organs involved in metastatic disease were significantly more likely to die within one month of immunotherapy initiation versus those with lymph node involvement only (adjusted odds ratio, 3.8). Compared with treatment at a nonacademic or very low-volume center, treatment at an academic or high-volume center was associated with lower odds of death within a month of initiating immunotherapy (odds ratios, 0.69 and 0.70, respectively).
“More research on the benefit and value of these therapies in patients with advanced-stage disease is needed,” the authors write.
Several authors disclosed ties to industry.
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