Evidence map›Paper›PMID 40466035›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2025

Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults With Cancer.

Javaid Iqbal, Rahim Moineddin, Kieran L Quinn, Christopher M Booth, Craig C Earle, Stephanie Lheureux, Robert Grant, Jenny Lau, Lisa W Le, Peter Tanuseputro and 8 more

Abstract read
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Javaid IqbalDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Rahim MoineddinDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-5506-084X
Kieran L QuinnDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-1681-5170
Christopher M BoothDepartment of Oncology, Queen's University, Kingston, ON, Canada.ORCID 0000-0002-1353-3653
Craig C EarleDepartment of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-0420-1999
Stephanie LheureuxInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-4405-5890
Robert GrantInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-9821-0377
Jenny LauDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0003-0947-7334
Lisa W LeDepartment of Biostatistics, University of Health Network, Toronto, ON, Canada.ORCID 0000-0002-0084-9915
Peter TanuseputroDepartment of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
James DownarDepartment of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0001-7479-1560
Gary RodinDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0002-6626-6974
Hsien SeowDepartment of Oncology, McMaster University, Hamilton, ON, Canada.ORCID 0000-0001-6701-1714
Jillian TsaiDepartment of Radiation Oncology, University of Toronto, and Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0003-0400-2655
Robert A FowlerDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Breffni HannonDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0002-0881-555X
Monika K KrzyzanowskaInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-5533-7418
Camilla ZimmermannDepartment of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.ORCID 0000-0003-4889-0244

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUse of chemotherapy at the end of life (EOL) is discouraged, but evidence to guide decisions on the use of novel systemic anticancer treatment (SACT) agents is lacking. We examined trends of use among SACT types and association with health services use at the EOL. MATERIALS AND

methodsWe analyzed Canadian Ontario Cancer Registry data for adults diagnosed with solid tumors or hematologic malignancies within 5 years of death who received SACT between March 2015 and March 2021. Receipt of SACT in the last 30 days of life was categorized as chemotherapy alone, chemotherapy and immunotherapy, immunotherapy alone, and targeted therapy alone. Outcomes included high health services use, including multiple (≥2) emergency department (ED) visits, multiple (≥2) hospitalizations, or any (≥1) intensive care unit admission, and hospital deaths. Segmented linear regression estimated monthly trends; multivariable logistic regression estimated adjusted odds ratios (aORs) of outcomes for various SACT types.

resultsAmong 68,963 patients, 18,337 (26.6%) received SACT at the EOL. From March 2015 to March 2020, use of SACT at the EOL increased (0.072% per month;

conclusionUse of SACT at the EOL increased significantly over time, driven by increased use of immunotherapy. SACT use at the EOL, regardless of its type, was associated with high health services use and hospital death. Guidelines on the use of SACT at the EOL should include novel cancer treatments.

Indexed as

Antineoplastic AgentsNeoplasmsTerminal CareAdultAgedAged, 80 and overFemaleHumansImmunotherapyMaleMiddle AgedOntarioRegistriesAntineoplastic Agents

Identifiers

PMID40466035
PMCPMC12527759

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.