She emphasized that hospitalization rates should be made “part of routine reporting of RCTs; we are collecting it, let’s also report it so the data are out there.”

Additional research is planned to develop a predictive model for hospitalization, trying to identify a patient type, certain disease characteristics, or drug characteristics that increase risk, Dr. Krzyzanowska said.


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Going forward, this information has potential to improve patient care. Clinicians “consider so many issues, and offer support in many areas,” said Dr. Krzyzanowska, “but what kind of support is being offered between patients’ clinic visits? What can be done better?”

For patients, she stressed that information empowers them by factoring in their values and priorities. “If patients have a limited life expectancy, how much is avoiding hospitalization worth to them? No one has asked patients, if you had comparable choices, but one had a lower hospitalization rate, what would you choose?”

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Although the data here are limited to mNSCLC patients, Dr. Krzyzanowska said she expects this “gap” in hospitalization will apply to patients with other cancer types and possibly to those receiving targeted therapies, but noted that can only be proved by further research.

“We have made such strides in improving treatment for patients, with therapies that make them live longer, that we now have to focus on the other part of this equation. What are the downstream effects of treatment and how do they affect patients’ quality of life?”

Reference

  1. Prince RM, Atenafu EG, Krzyzanowska MK. Hospitalizations during systemic therapy for metastatic lung cancer: a systematic review of real world versus clinical trials outcomes. [published online ahead of print September 17, 2015]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.3440.