Effects of molecular targeting agents and immune-checkpoint inhibitors in patients with advanced cancer who are near the end of life
- 17 March 2021
- journal article
- research article
- Published by Cambridge University Press (CUP) in Palliative & Supportive Care
- Vol. 19 (6), 709-714
- https://doi.org/10.1017/s147895152100002x
Abstract
Background In recent years, the use of both molecular targeting agents (MTAs) and immune-checkpoint inhibitors (ICIs) tend to occupy important positions in systemic anticancer therapy (SACT). The objective of this study is to describe the predictors of SACT include both MTAs and ICIs near the end of life (EOL) and the effect on EOL care in patients with advanced cancer. Methods We analyzed all patients who died of advanced cancer from August 2016 to August 2019, and we analyzed the survival time of patients who underwent anticancer agents excluded due to the loss of information about the last administration of SACT. The primary endpoint of this study was to identify predictors during the last administration of SACT near EOL. Results In a multivariate analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS) (ORs 33.781) was significantly related factors within 14 days of death from the last administration of SACT. Age (ORs 0.412), ECOG-PS (ORs 11.533), primary cancer site of upper GI cancers (ORs 2.205), the number of comorbidities (ORs 0.207), MTAs (ORs 3.139), and ICIs (ORs 3.592) were significantly related factors within 30 days of death. The median survival time (MST) of patients with PS 3–4 was 29 days, while that of patients with both PS 0–2 was 76 days. The prevalence rate of delirium with MTAs was 17.5%, which was significantly lower than that of patients without it (31.8%). The prevalence rate of the mean dose of opioids in patients with ICIs was 97.9 mg/day, which was significantly higher than that of patients without it (44.9 mg/day). Conclusions Age, ECOG-PS, primary cancer site, the number of comorbidities, MTAs, and ICIs use were significant associated with SACT near EOL. Information on these factors may aid clinical decision making in referral to palliative care institutes.Keywords
This publication has 22 references indexed in Scilit:
- Targeted Agent Use in Cancer Patients at the End of LifeJournal of Pain and Symptom Management, 2012
- American Society of Clinical Oncology Identifies Five Key Opportunities to Improve Care and Reduce Costs: The Top Five List for OncologyJournal of Clinical Oncology, 2012
- Palliative chemotherapy during the last month of lifeAnnals of Oncology, 2011
- Factors That Affect the Duration of the Interval Between the Completion of Palliative Chemotherapy and DeathThe Oncologist, 2009
- Use of chemotherapy at end of life in oncology patientsAnnals of Oncology, 2009
- First-Line Gefitinib for Patients With Advanced Non–Small-Cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations Without Indication for ChemotherapyJournal of Clinical Oncology, 2009
- The aggressiveness of cancer care in the last three months of life: a retrospective single centre analysisPsycho‐Oncology, 2007
- Development of a Clinical Guideline for Palliative Sedation Therapy Using the Delphi MethodJournal of Palliative Medicine, 2005
- Trends in the Aggressiveness of Cancer Care Near the End of LifeJournal of Clinical Oncology, 2004
- Clarifying Confusion: The Confusion Assessment MethodAnnals of Internal Medicine, 1990