Retrospective chart review of end-of-life (EOL) care in patients with metastatic lung cancer harboring EGFR mutations.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 126-126 ◽  
Author(s):  
Jessica Ruth Bauman ◽  
Zofia Piotrowska ◽  
Emily Scribner ◽  
Brandon Temel ◽  
Rebecca Suk Heist ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Chart Review ◽  
Median Number ◽  
Egfr Mutations ◽  
Care Utilization ◽  
Metastatic Lung Cancer ◽  
Metastatic Lung ◽  
Egfr Mutant ◽  
Eol Care

126 Background: Metastatic lung cancer is the leading cause of cancer-related death in the US. In the last decade, however, patients (pts) with EGFR mutations have benefitted from improved outcomes with EGFR-directed targeted therapy. We hypothesized that this improvement might impact EOL care. The objective of this chart review was to describe the care of EGFR mutant pts with attention to EOL care, health care utilization, and palliative care use. Methods: With IRB approval, we retrospectively reviewed medical records of pts at our center diagnosed with advanced EGFR-mutant lung cancer from January 2009 to June 2012. We limited the review to pts who had at least one cancer therapy at MGH, and to those who died by June 2014. Results: 44 pts were included. 30 pts (68%) were female. 32 pts (73%) received cancer-directed therapy within 30 days of death. Of these, 30 pts (68%) received oral chemotherapy and 5 (11%) received IV chemotherapy. 30 pts (68%) were hospitalized within 30 days of death. Over their entire disease course, the median number of hospitalizations was 2 (0-8), and the median number of total inpatient days was 12 (0-88). 21 pts (48%) had a palliative care outpatient visit and 34 (77%) had an inpatient palliative care consult at some point during their care. 24 pts (54%) enrolled on hospice prior to death, 15 (34%) were never on hospice, and the hospice status of 5 (11%) was unknown. Of the 39 pts with known hospice status, median length of stay was 6 days (0-206). 23 pts (52%) died at home with hospice or in an inpatient hospice, 16 (36%) died in the hospital, 2 (4%) died at home without hospice, and the location of death was unknown for 3 (7%). Conclusions: Pts with EGFR mutations had high rates of hospitalization and chemotherapy use in the last month of life, and many died in the hospital. Palliative care utilization was high, but it is unclear how this affected EOL care. Designing innovative care models to support this unique population and understand EOL decision-making should be a priority.

End of life (EOL) care in patients with metastatic lung cancer harboring EGFR-mutations.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e20508-e20508
Author(s):  
Jessica Ruth Bauman ◽  
Zofia Piotrowska ◽  
Emily Scribner ◽  
Brandon Temel ◽  
Lecia V. Sequist ◽  
...  
Keyword(s):  
Lung Cancer ◽  
End Of Life ◽  
Egfr Mutations ◽  
Metastatic Lung Cancer ◽  
Metastatic Lung ◽  
Eol Care

scholarly journals Use of Curcumine with Tyrosine Kinase Inhibitors in EGFR-mutant Non-Small Cell Lung Cancer. A Phase I prospective Cohort Trial

2021 ◽  
Vol 7 (5) ◽  
pp. 1-8
Author(s):  
Goulnar Kasymjanova ◽  
Keyword(s):  
Lung Cancer ◽  
Kinase Inhibitors ◽  
Small Cell ◽  
Prospective Clinical Study ◽  
Metastatic Lung Cancer ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Metastatic Lung ◽  
Egfr Mutant ◽  
Egfr Tkis

Our study is the first prospective clinical study using combination of curcumin and EGFR-TKIs in metastatic lung cancer patients. The future randomized larger-scale clinical trials using this combination is feasible and safe. RCT will seek to assess the potential effects on survival and response to TKIs

scholarly journals Intratumoral distribution of EGFR mutations and copy number in metastatic lung cancer, what impact on the initial molecular diagnosis?

2014 ◽  
Vol 12 (1) ◽  
pp. 131 ◽  
Author(s):  
Audrey Mansuet-Lupo ◽  
Fouzia Zouiti ◽  
Marco Alifano ◽  
Anne Tallet ◽  
Marie-Christine Charpentier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Molecular Diagnosis ◽  
Copy Number ◽  
Egfr Mutations ◽  
Metastatic Lung Cancer ◽  
Metastatic Lung ◽  
Intratumoral Distribution

Integration of palliative care services into standard oncology practice at diagnosis of metastatic lung cancer at VA New York Harbor Healthcare System.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 165-165
Author(s):  
Felix Manuel Rivera Mercado ◽  
Carol Luhrs ◽  
Alice Beal ◽  
Maura Langdon ◽  
Joan Secrest ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Stage Iv ◽  
Major Advance ◽  
Metastatic Lung Cancer ◽  
Care Services ◽  
National Quality ◽  
Metastatic Lung ◽  
Palliative Care Services ◽  
Oncology Practice

165 Background: The 2012 ASCO provisional clinical opinion addressed the integration of palliative care into standard oncology practice at the time a person is diagnosed with metastatic or advanced cancer. The inclusion of Palliative Care among the National Quality Forum (NQF) framework represented a major advance in palliative care. NQF metrics include chemotherapy administered in the last 14 days of life, hospice less than 3 days before death, ICU or hospital admission, more than one Emergency Room visit in the last 30 days, and death in hospital. Although the use of hospice and other palliative care services has increased, many are enrolled in hospice less than 3 weeks before death. By improving quality of life, cost, and survival in patients with metastatic cancer, palliative care has increasing relevance for the care of patients with cancer. Methods: Retrospective chart review study of lung cancer patients diagnosed at VA from 2010-2013. Inclusion criteria: > 18 years of age with new diagnosis of metastatic lung cancer. Exclusion criteria: < 18 years of age, Stage I-III lung cancer. Results: Total of 125 patients were diagnosed with Stage IV lung cancer. The mean time from diagnosis to death was only 185 days (6.1 months). The VA NYHHS patients were more likely to visit the ED, be admitted to the hospital and ICU in the last 30 days of life, and subsequently die in the hospital. Conclusions: Several confounders were identified, including climate related closure of facilities (2012 Sandy storm), lack of social support, low ICU admission criteria, burial benefits for patients dying in a VA, and delay in transition to Hospice. Currently 392 patients with stage IV solid tumors diagnosed 2010-2014 are being studied. [Table: see text]

scholarly journals The Importance of Brain Metastasis in EGFR Mutation Positive NSCLC Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Vanita Noronha ◽  
Amit Joshi ◽  
Anant Gokarn ◽  
Vibhor Sharma ◽  
Vijay Patil ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Egfr Mutation ◽  
Egfr Mutations ◽  
Rank Test ◽  
Metastatic Lung Cancer ◽  
Lung Cancer Patients ◽  
Metastatic Lung ◽  
Extracranial Metastases

Introduction. Brain metastasis is a poor prognostic marker in lung cancer. However it is not known whether amongst patients with EGFR mutation those with brain metastases have a worse outcome. Methods. We compared the survival outcomes between EGFR mutation positive patients with and without brain metastases. In this retrospective analysis of prospective database of all metastatic lung cancer patients at our centre between July 2009 and December 2012, patients were treated with either combination chemotherapy or oral TKI. All patients with brain metastases received whole brain radiation. Kaplan Meier method was used for survival analysis and compared using log rank test. Results. 101 patients with EGFR mutated, metastatic lung cancer were studied. Fourteen had brain metastases and 87 did not. The common EGFR mutations were exon 19 deletion (61.3%) and exon 21 L858R mutation (28.7%). Overall response was 64% in extracranial metastasis group as compared to 50% in brain metastasis group. There was a significant worsening of median OS in the patients with brain metastases (11.6 months) compared with only extracranial metastases (18.7 months), P=0.029. Conclusion. Amongst patients with EGFR mutant NSCLC, the presence of brain metastases leads to a worse outcome as compared to patients with extracranial metastases alone.

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