Real-World Use of Chemotherapy During End of Life in Patients with Metastatic Breast Cancer

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The use of chemotherapy in patients with metastatic breast cancer during end of life may cause unnecessary toxicity and negatively impact patient quality of life. However, available data on patients during the final month of life are scarce. Researchers in Sweden and Greece sought to learn more about the patterns of chemotherapy use and the associated clinical and demographic characteristics of patients with metastatic breast cancer during the last month of life.

This retrospective cohort study collected data on clinical characteristics, survival, and use of chemotherapy during the final 30 days of life. Hospital charts were used to identify treatment data from 1571 Swedish and 2501 Greek patients.

During the final 30 days of life, 23.2% of patients in the Swedish cohort were treated with ≥1 doses of chemotherapy and a new chemotherapy regimen was initiated in 8.4% of patients. Capecitabine or vinorelbine monotherapy were the most frequently prescribed regimens. A median overall survival rate of 16.96 months (95% confidence interval [CI], 15.4-18.4) was observed. Conversely, 46.5% of the Greek cohort received chemotherapy, with 19.5% of patients starting a new chemotherapy regimen at the end of life. The most common therapy was intravenous drug combinations. The median overall survival rate was 49.8 months (95% CI, 45.6-54.1). Younger age and higher albumin levels were statistically significantly associated with chemotherapy use during the end of life in the Swedish cohort. However, in the Greek cohort there was no association between age, receptor status, or number of treatment lines and the likelihood of receiving chemotherapy in the final 30 days of life.

Recognition of the common use of chemotherapy and its potential negative impact on quality of life during the final month of life of patients with metastatic breast cancer is essential to efforts to mitigate this practice.

Source:

Kessler EL, Sigfridsson J, Hatzidaki D, et al. Chemotherapy use near the end‑of‑life in patients with metastatic breast cancer. Breast Cancer Res Treat. 2020;181:645-651.

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