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 language | English |
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Pages (from-to) | 831-836 |
Number of pages | 6 |
Journal | Journal of Palliative Medicine |
Volume | 26 |
Issue number | 6 |
DOIs | |
State | Published - 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