End-of-Life Use of Systemic Therapy in Patients With Advanced Melanoma: A Nationwide Cohort Study

Autor: Jesper van Breeschoten, Rawa K. Ismail, Michel W.J.M. Wouters, Doranne L. Hilarius, Liesbeth C. de Wreede, John B. Haanen, Christian U. Blank, Maureen J.B. Aarts, Franchette W.P.J. van den Berkmortel, Jan Willem B. de Groot, Geke A.P. Hospers, Ellen Kapiteijn, Djura Piersma, Rozemarijn S. van Rijn, Marion A. Stevense-den Boer, Astrid A.M. van der Veldt, Gerard Vreugdenhil, Marye J. Boers-Sonderen, Karijn P.M. Suijkerbuijk, Alfons J.M. van den Eertwegh
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS), Medical Oncology, Radiology & Nuclear Medicine, Internal medicine, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Medical oncology, CCA - Cancer Treatment and quality of life, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Rok vydání: 2022
Předmět:
Zdroj: JCO oncology practice, 18(10):e1611
JCO Oncology Practice, 18(10), e1611-e1620. American Society of Clinical Oncology
None
JCO oncology practice, 18(10), e1611-e1620. Lippincott Williams and Wilkins Ltd.
van Breeschoten, J, Ismail, R K, Wouters, M W J M, Hilarius, D L, de Wreede, L C, Haanen, J B, Blank, C U, Aarts, M J B, van den Berkmortel, F W P J, de Groot, J W B, Hospers, G A P, Kapiteijn, E, Piersma, D, van Rijn, R S, Stevense-den Boer, M A, van der Veldt, A A M, Vreugdenhil, G, Boers-Sonderen, M J, Suijkerbuijk, K P M & van den Eertwegh, A J M 2022, ' End-of-Life Use of Systemic Therapy in Patients With Advanced Melanoma : A Nationwide Cohort Study ', JCO oncology practice, vol. 18, no. 10, pp. e1611-e1620 . https://doi.org/10.1200/OP.22.00061
JCO Oncology Practice, 18, 10, pp. e1611-e1620
JCO Oncology Practice, 18(10), e1611-e1620. LIPPINCOTT WILLIAMS & WILKINS
JCO Oncology Practice, 18, e1611-e1620
ISSN: 2688-1527
2688-1535
DOI: 10.1200/OP.22.00061
Popis: PURPOSE: The introduction of immune checkpoint inhibitors and targeted therapies improved the overall survival of patients with advanced melanoma. It is not known how often these costly treatments with potential serious side effects are ineffectively applied in the last phase of life. This study aimed to investigate the start of a new systemic therapy within 45 and 90 days of death in Dutch patients with advanced melanoma. METHODS: We selected patients who were diagnosed with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry, and died between 2013 and 2019. Primary outcome was the probability of starting a new systemic therapy 45 and 90 days before death. Secondary outcomes were type of systemic therapy started, grade 3/4 adverse events (AEs), and the total costs of systemic therapies. RESULTS: Between 2013 and 2019, 3,797 patients with unresectable IIIC or stage IV melanoma were entered in the registry and died. The percentage of patients receiving a new systemic therapy within 45 and 90 days before death was significantly different between Dutch melanoma centers (varying from 6% to 23% and 20% to 46%, respectively). Thirteen percent of patients (n = 146) developed grade 3/4 AEs in the last period before death. The majority of patients with an AE required hospital admission (n = 102, 69.6%). Mean total costs of systemic therapy per cohort year of the patients who received a new systemic therapy within 90 days before death were 2.3%-2.8% of the total costs spent on melanoma therapies. CONCLUSION: The minority of Dutch patients with metastatic melanoma started a new systemic therapy in the last phase of life. However, the percentages varied between Dutch melanoma centers. Financial impact of these therapies in the last phase of life is relatively small.
Databáze: OpenAIRE
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