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Real-World Financial Toxicity in Patients Receiving Cancer Immunotherapy

February 14, 2020

Financial toxicity may be prevalent in certain patients with cancer who receive immunotherapy treatment, according to the results of a survey of real-world patients.

Results were presented at the 2020 American Society of Clinical Oncology (ASCO)-SITC Clinical Immuno-Oncology Symposium (February 6-8, 2020; Orlando, FL).

Daniel A Vorobiof, MD, chief medical officer,, reported real-world evidence data on 105 users of the—a cancer patient and caregiver mobile social network—who received immunotherapy for various cancers. Patients were asked in a survey to reply to 14 questions related to their financial toxicity while on treatment, the most common encountered causes of financial toxicity, and their personal financial coping strategies.

Researchers noted that 79% of patients were in the US, 21% were younger than 50 years, 32% were aged 51 to 60 years, and 47% were older than 61 years. Additionally, most cancers in the sample were stage IV (62%), followed by stage III (23%) and unknown stage (15%).

Among the most common cancer diagnoses were lung (46%), kidney (17%), malignant melanoma (14%), and colorectal (10%). The most commonly used immunotherapy agents were nivolumab (36%), pembrolizumab (36%), ipilimumab (14%), and durvalumab (10%).

Patients reported the most frequent reasons for financial toxicity were high medical copayments (35%), loss of income (33%), and high drug and treatment copayments (21%). Forty-one percent of patients were insured by Medicare and 25% were insured by Medicaid or other HMOs.

Dr Vorobiof and colleagues found that only 48% of patients were aware of possible financial difficulties as a result of their diagnosis and treatment, and 34% received pretreatment financial counseling from their doctors – which reduced the reported financial toxicity from 48% to 30%. When asked about financial coping strategies, 39% of patients used personal savings, 28% reduced their private expenses, and 24% received financial support from the friends and families.

In their concluding remarks, Dr Vorobiof and colleagues noted that physicians should become aware of their patient’s possible risks for financial toxicity and appropriate advice should be given prior to immunotherapy initiation.—Zachary Bessette

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