Ramy Sedhom: Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults with Cancer
Ramy Sedhom, Clinical Director of Palliative Care at Penn Medicine Princeton Health, posted on X:
“Important findings from Journal of Clinical Oncology on systemic anticancer treatments at EOL.
EY FINDINGS from 68,963 cancer patients:
- 26.6% received systemic therapy in last 30 days of life
- Immunotherapy use at EOL significantly high
SOBERING REALITY: Patients receiving ANY systemic therapy at EOL had:
- 2x higher odds of multiple hospitalizations.
- 2x higher odds of ICU admissions.
- 2.6x higher odds of hospital death.
- This included immunotherapy and targeted therapies.
We often view immunotherapy/targeted agents as “more tolerable” options, but this data challenges that assumption for EOL care. The association with poor-quality death metrics persisted across ALL treatment modalities.
Quality metrics (NQF) should expand beyond chemotherapy: we need earlier, iterative goals-of-care conversations and to consider 30-day (vs 14-day) timeframe for EOL treatment metrics.
Our patients deserve honest prognostic discussions and quality EOL care. Even “novel” therapies don’t change the fundamental importance of knowing when to shift focus from disease-directed to comfort-focused care.”
Title: Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults With Cancer
Authors: Javaid Iqbal, Rahim Moineddin, Kieran L. Quinn, Christopher M. Booth, Craig C. Earle, Stephanie Lheureux, Robert Grant, Jenny Lau, Lisa W. Le, Peter Tanuseputro, James Downar, Gary Rodin, Hsien Seow, Jillian Tsai, Robert A. Fowler, Breffni Hannon, Monika K. Krzyzanowska, Camilla Zimmermann
Read The Full Article at Journal of Clinical Oncology.
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