Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer

Laurie E. McLouth, Jennifer Gabbard, Beverly J. Levine, Shannon L. Golden, Thomas W. Lycan, W. Jeffrey Petty, Kathryn E. Weaver

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: This study describes patients' prognostic awareness and palliative care use in the setting of immunotherapy for metastatic non-small cell lung cancer (mNSCLC). Design: We surveyed 60 mNSCLC patients receiving immunotherapy at a large academic medical center; conducted follow-up interviews with 12 survey participants; and abstracted palliative care use, advance directive completion, and death within a year of survey completion from the medical record. Results: Forty seven percent of patients surveyed thought they would be cured; 83% were not interested in palliative care. Interviews suggested oncologists emphasized therapeutic options when discussing prognosis and that commonly used descriptions of palliative care may exacerbate misperceptions. Only 7% had received outpatient palliative care and 8% had an advance directive a year after the survey; only 16% of the 19 patients who died had received outpatient palliative care. Conclusions: Interventions are needed to facilitate prognostic discussions and outpatient palliative care during immunotherapy. Clinical Trial Registration Number NCT03741868.

Original languageEnglish
Pages (from-to)831-836
Number of pages6
JournalJournal of Palliative Medicine
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2023

Bibliographical note

Funding Information:
This study was supported by the Lung Cancer Initiative of North Carolina Research Fellow Grant (L.E.M.) and the Wake Forest CTSA Grant UL1TR001420. L.E.M. was supported by NCI R25CA122061 (PI: Avis), 2 KL2 TR 001996-05A1. This study was also supported by the Qualitative and Patient-Reported Outcomes (Q-PRO) Shared Resource of the Comprehensive Cancer Center of Wake Forest University (CCCWFU), P30 CA012197.

Publisher Copyright:
© 2023, Mary Ann Liebert, Inc., publishers.

Keywords

  • immunotherapy
  • nivolumab
  • non-small cell lung cancer
  • palliative care
  • pembrolizumab
  • treatment expectations

ASJC Scopus subject areas

  • Nursing (all)
  • Anesthesiology and Pain Medicine

Fingerprint

Dive into the research topics of 'Prognostic Awareness, Palliative Care Use, and Barriers to Palliative Care in Patients Undergoing Immunotherapy or Chemo-Immunotherapy for Metastatic Lung Cancer'. Together they form a unique fingerprint.

Cite this