A new study has found that a common type of cancer treatment, called immune checkpoint inhibitors (ICIs), may not be very effective for patients who receive them while hospitalized. Researchers at the Icahn School of Medicine at Mount Sinai analyzed data from multiple hospitals and concluded that most patients did not benefit from this treatment.
ICIs are a type of immunotherapy, which means they help the body’s immune system fight cancer. These drugs have been successful in treating some types of cancer, especially for patients who are not in the hospital.
However, this study suggests that giving them to hospitalized patients might not work well. In fact, many patients who received ICIs in the hospital had very poor outcomes.
The researchers looked at the medical records of 215 patients from multiple hospitals, including Stanford, Georgetown, Yale, and the University of Pennsylvania. They found that after receiving ICIs in the hospital, the median survival time was only one and a half months. About 25% of these patients died before even leaving the hospital.
Only 12% of patients seemed to benefit from the treatment at all. The study did not find any specific factors, such as age or type of cancer, that could predict which patients would respond well to ICIs.
Dr. Deborah Doroshow, one of the lead researchers, explained why ICIs might not work well for hospitalized patients. She pointed out that these drugs usually take two to six months to start working.
However, many hospitalized cancer patients have very advanced disease and may not have enough time for the treatment to take effect. Because of this, using ICIs in a hospital setting may not be the best choice for most patients.
Another challenge with ICIs is their cost. These treatments are very expensive, and many hospitals already limit their use because they are not covered by insurance in all situations. This study adds another reason to be cautious about using them for patients who are already very sick and staying in the hospital.
Doctors and hospitals may need to reconsider how they use ICIs for hospitalized patients. While many physicians hope that a patient will be an exception and respond well to treatment, the study shows that this is very rare.
Dr. Doroshow emphasized that both doctors and families should understand that the benefits of ICIs in a hospital setting are very limited. Even though ICIs have been life-changing for some cancer patients, they may not be the right choice for those who are already very ill and require hospital care.
Analysis and Implications
This study provides important new information about when ICIs should and should not be used. While these drugs have transformed cancer treatment for many people, they may not be useful for patients who are already in critical condition.
The research supports the idea that ICIs work best when given earlier in the course of cancer treatment, rather than as a last resort in the hospital.
The findings could also help guide hospital policies. Some hospitals already limit the use of ICIs due to their high cost, and this study gives them clinical evidence to support those decisions.
Doctors may need to have more conversations with patients and their families about the realistic benefits and risks of this treatment in a hospital setting.
Overall, while ICIs remain an important tool in cancer treatment, this study highlights the need for careful decision-making when it comes to their use in hospitalized patients.
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The research findings can be found in JCO Oncology Practice.
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