In patients with non–small-cell lung cancer (NSCLC), tyrosine kinase inhibitor (TKI) therapy, immunotherapy, and chemotherapy are small contributors to unplanned acute hospital care (JCO Oncol Pract. 2020;OP2000612. doi:10.1200/OP.20.00612).
“In lung cancer, unplanned hospital care is a significant driver of costs. While toxicities of cancer therapies are well-known, there are little data on their relative contribution to unplanned care,” wrote Manan Shah, MD, and Joel Neal, MD, PhD, both from the Department of Medicine, Division of Oncology, Stanford University, California.
This study aimed to determine the relative impact of anticancer therapy on unplanned hospital care, as well as identify potential strategies to prevent unplanned hospital utilization in patients with NSCLC.
Patients with NSCLC who were undergoing TKI therapy, immune checkpoint inhibitor immunotherapy, or cytotoxic chemotherapy and who visited the emergency department (ED) in 2018 were identified using a database search of the electronic health record.
A total of 97 patients and 173 ED admissions were identified. These 173 cases were reviewed in order to determine the cause of each encounter and whether it was preventable.
Cancer itself (54%) was the leading cause of hospital encounters with a small portion (9%) being therapy related (2% in the TKI therapy group, 12% in the immunotherapy group, and 21% in the chemotherapy group). Preventable encounters made up 20% of all encounters and half of those were unnecessary.
“TKI therapy, immunotherapy, and, to a lesser extent, chemotherapy are relatively small drivers of unplanned acute hospital care for patients with NSCLC,” concluded Drs Shah and Neal.
“A significant share of unplanned hospital encounters may be prevented through proactive evidence-based initiative,” they added.—Lisa Kuhns
