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Immune Checkpoint Inhibitor Use Near the End of Life Is Associated With Poor Performance Status, Lower Hospice Enrollment, and Dying in the Hospital.
Glisch, Chad; Hagiwara, Yuya; Gilbertson-White, Stephanie; Gao, Yubo; Lyckholm, Laurel.
Afiliação
  • Glisch C; Department of Medicine, Supportive and Palliative Care Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Hagiwara Y; Department of Medicine, Supportive and Palliative Care Program, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Gilbertson-White S; College of Nursing, University of Iowa, Iowa City, IA, USA.
  • Gao Y; Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
  • Lyckholm L; Division of Hematology, Oncology, Blood and Marrow Transplantation, Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Am J Hosp Palliat Care ; 37(3): 179-184, 2020 Mar.
Article em En | MEDLINE | ID: mdl-31307205
BACKGROUND: 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. METHODS: 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. RESULTS: 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%], P = .007) and higher rates of dying in the hospital (23 [56%] vs 33 [29%], P = .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%], P = .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. CONCLUSION: 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Admissão do Paciente / Assistência Terminal / Avaliação de Estado de Karnofsky / Hospitais para Doentes Terminais / Neoplasias / Antineoplásicos Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Hosp Palliat Care Assunto da revista: ENFERMAGEM Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Admissão do Paciente / Assistência Terminal / Avaliação de Estado de Karnofsky / Hospitais para Doentes Terminais / Neoplasias / Antineoplásicos Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Am J Hosp Palliat Care Assunto da revista: ENFERMAGEM Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos