Patterns of End-of-Life Oncologic Care for Stage IV Non-small Cell Lung Cancer in the United States

Background/Aim: Because aggressive oncological management just prior to death constitutes a substantial proportion of end-of-life (EOL) costs, we investigated patterns of EOL oncologic care for stage IV non-small cell lung cancer (NSCLC) in USA to better determine at which point in the patient’s management new treatments were being initiated. Materials and Methods: The National Cancer Database was queried for stage IV NSCLC patients who received any cancer-directed therapy with known timing thereof. Results: A total of 281,990 stage IV NSCLC patients were analyzed. Of all patients, 10.8% commenced any first-course cancer therapy within four weeks of death, and 24.5% within eight weeks of death. Conclusion: 10-15% of stage IV NSCLC patients start cancer therapy within four weeks of death, and 25-30% within eight weeks. This represents a population for whom cancer therapy may not be required, which has implications on reducing EOL healthcare costs.