Systemic therapy may offer no significant improvement in overall survival in patients with advanced solid tumors, according to a recent study published by Canavan et al in JAMA Oncology.
Study Methods and Results
In the recent study, the investigators analyzed the de-identified data of over 78,000 adult patients who were diagnosed between 2015 and 2019 with metastatic or advanced breast cancer, colorectal cancer, non–small cell lung cancer, pancreatic cancer, renal cell carcinoma, and urothelial carcinoma. The patients subsequently received treatment at 144 community oncology practices and academic/research centers.
The investigators then stratified the oncology practices by how frequently health-care providers administered systemic therapy for advanced solid tumors and examined the patients’ overall survival rates. They found no statistically significant differences in patient survival among practices that administered more systemic therapy for advanced solid tumors compared with those that administered less.
Conclusions
The recent findings may help oncologists communicate with patients that additional cancer-directed therapy may offer little to no benefit, allowing them to focus instead on palliative and supportive care options that have been demonstrated to improve quality of life and survival.
“Our study highlights the importance of open and honest communication about prognosis between providers and patients. Our findings may help oncologists reconsider treatment and instead provide patients with transparent information on supportive care options so they are able to make informed decisions,” underscored senior study author Kerin Adelson, MD, Chief Quality and Value Officer at The University of Texas MD Anderson Cancer Center. “A large body of research has shown that goals-of-care conversations are critical to ensuring patients receive care in line with their prognosis and personal goals. This is even more critical when we know additional therapy will not improve a patient’s survival, but only cause toxicity and harm,” she concluded.
The investigators are currently working to streamline early conversations about goals of cancer care and ensure goal-concordant care for patients with solid tumors by using a multidisciplinary approach that integrates patients’ individual values and goals into their treatment strategies. They hope to identify novel methods for restructuring and realigning resources related to palliative and end-of-life care.
Disclosure: The research in this study was supported by Flatiron Health. For full disclosures of the study authors, visit jamanetwork.com.
