Researchers have identified several factors that may affect the risk of early mortality among patients with breast and lung cancer, according to a recent study.
In a study published in The Lancet Oncology, researchers led by David Dodwell, MD, St James Hosptial (Leeds, United Kingdom), aimed to establish national 30-day mortality benchmarks for patients with breast or lung cancer receiving systemic anticancer therapy (SACT) in England and identify areas in which care could be improved.
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Patients included in the study were all women and aged 24 years or older who had started a cycle of SACT in 2014. Researchers did not consider previous treatment cycles or programmes, nor patients’ position within disease trajectory.
A total of 23,228 patients with breast cancer and 9634 patients with non-small cell lung cancer were included in the final analysis. Using logistic regression analyses, researchers found that 30-day mortality increased with age for both cohorts treated with curative intent and decreased for both with age. Additionally, 30-day mortality was significantly higher among those receiving their first curative or palliative SACT compared with patients who had received SACT previously (breast palliative: OR 2·326 99% CI 1·634–3·312; p<0·0001; NSCLC curative: 3·371, 1·554–7·316; p<0·0001; NSCLC palliative: 2·667, 2·109–3·373; p<0·0001).
30-day mortality was also higher for patients with worse general wellbeing, (performance status 2-4) versus those who were generally well (breast curative: 6·057, 1·333–27·513; p=0·0021; breast palliative: 6·241, 4·180–9·319; p<0·0001; NSCLC palliative: 3·384, 2·276–5·032; p<0·0001).
Researchers concluded that there are several factors that can influence 30-day mortality in patients with breast and lung cancer, highlighting the importance of collecting routine data beyond clinical trials in order to improve clinical decision making.
“In order to maximise the benefits of systemic treatment, it is important to gain a detailed understanding of how many different factors affecting patients are linked to the increased risk of early mortality," said Dr Dodwell. “"Patient choice is an important factor in decisions about treatment and the factors we have identified may provide a focus of discussions about treatment between patients and their clinicians to allow better informed decisions."
