Chemotherapy and Tyrosine Kinase Inhibitors in the last month of life in patients with metastatic lung cancer: A patient file study in the Netherlands.

Abstract

OBJECTIVE:

Chemotherapy in the last month of life for patients with metastatic lung cancer is often considered as aggressive end-of-life care. Targeted therapy with Tyrosine Kinase Inhibitors (TKIs) is a relatively new treatment of which not much is known yet about use in the last month of life. We examined what percentage of patients received chemotherapy or TKIs in the last month of life in the Netherlands.

METHODS:

Patient files were drawn from 10 hospitals across the Netherlands. Patients had to meet the following eligibility criteria: metastatic lung cancer; died between June 1, 2013 and July 31, 2015.

RESULTS:

From the included 1,322 patients, 39% received no treatment for metastatic lung cancer, 52% received chemotherapy and 9% received TKIs. A total of 232 patients (18%) received treatment in the last month of life (11% chemotherapy, 7% TKIs). From the patients who received chemotherapy, 145 (21%) received this in the last month of life and 79 (11%) started this treatment in the last month of life. TKIs were given and started more often in the last month of life: from the patients who received TKIs, 87 (72%) received this treatment in the last month of life and 15 (12%) started this treatment in the last month of life.

CONCLUSION:

A substantial percentage of patient received and even started chemotherapy or TKIs in the last month of life. For chemotherapy, this might be seen as aggressive care. TKIs are said to have less side effects, do not lead to many hospital visits and due to the rapid response, are considered good palliation. However, it is not known, yet possible that, when patients still receiving treatment until shortly before death, this might influence preparing for death in a negative way.

• Authors: Adinda Mieras, Annemarie Becker-Commissaris, H Roeline W Pasman, Anne-Marie M C Dingemans, Edith V Kok, Robin Cornelissen, Wouter Jacobs, Jan Willem van den Berg, Alle Welling, Brigitte A H A Bogaarts, Lemke Pronk, Bregje D Onwuteaka-Philipsen
• Journal: European journal of cancer care (Eur J Cancer Care (Engl)) Vol. 29 Issue 2 Pg. e13210 (Mar 2020) ISSN: 1365-2354 [Electronic] England
• PMID: 31863609 (Publication Type: Journal Article)
• Copyright: © 2019 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

Chemical References

• Antineoplastic Agents
• Protein Kinase Inhibitors

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Non-Small-Cell Lung (drug therapy, genetics, secondary)
• Comorbidity
• Female
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Male
• Middle Aged
• Netherlands
• Oncologists (statistics & numerical data)
• Palliative Care
• Protein Kinase Inhibitors (therapeutic use)
• Retrospective Studies
• Small Cell Lung Carcinoma (drug therapy, secondary)
• Terminal Care