Chemotherapy for advanced cancer didn’t improve survival

June 12, 2024

Source: Canavan, ME et al JAMA Oncology May 16, 2024 LINK

JAMA Oncology published research last month that compared the outcomes of oncologists in the one-fifth of practices that were most likely to prescribe aggressive treatment at the end of life with the outcomes of the fifth of oncologists who were least likely to prescribe such treatment. They focused on treatment given to almost 80,000 people with six solid tumors.

The researchers found that patients of the more aggressive oncologists were three times more likely to get end of life chemotherapy if they had lung cancer, and four times as likely to get end of life chemotherapy if they had colorectal cancer.

Most importantly, the researchers found that there was no survival advantage of being cared for at a practice that used more end-of-life aggressive treatment.

Implications for employers:

• Centers of Excellence programs can direct patients to oncologists with better quality scores. Oncologists with a pattern of more futile care have poorer scores on such quality measures.

• There is excellent evidence that those patients who receive palliative care have higher quality end of life care, and some evidence that on average they live longer. Employers can check their plan documents to be sure they provide coverage for palliative and hospice care.

• Employers can update their benefits so that individuals can use hospice care without a terminal diagnosis.

Tomorrow: Thursday shorts

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