OBJECTIVES: Patients with terminal cancer often need comprehensive care during their final months. As part of a larger data collection, we looked at end-of-life resource use of patients with end-stage non-small cell lung cancer (NSCLC). Given the rapidly evolving NSCLC treatment landscape, access to the latest real-world data (RWD) is crucial for diverse research needs.

METHODS: In the study, we included electronic health records of patients diagnosed with NSCLC between January 2013 to August 2023 in HUS, Helsinki University Hospital, Finland, that died during the study period. The specialized resource use (treatments, radiotherapy, ER visits, hospital admissions, ICU admissions, and palliative care) during the last 31 days of life was analyzed. Palliative care was assessed during 2020-2023 and ICU admissions 2013-2019 due to data availability.

RESULTS: A total of 6 248 patients were diagnosed with NSCLC, of whom 4 474 (71.6%) died during the study period. Of these, 40.7% were female and mean age at death was 73 years. Patients initiated their last line of treatment (including chemo-, ICI- (immune checkpoint inhibitor), or Tyrosine Kinase Inhibitor-therapy) a median of 171 days (IQR: 79-344) before death. The median time from last chemo- or ICI-therapy administration was 127 days (IQR: 56-294). 44% were admitted to specialized palliative care. In their last month of life, patients had an average of 0.15 (SD:0.8) chemo- or ICI-therapy administrations, 1 (SD:2.6) radiotherapy visit, 5.8 inpatient days (SD:8.0), and 6.4% had ICU admissions.

CONCLUSIONS: Comprehensive pre-existing RWD datasets can offer quick access to support decision-making in balancing resource use. Decisions on end-of-life-care may exclude treatments that provide no medical benefit for the patient. Some patients received chemo- or ICI-treatment in their last month of life, indicating an increasing need of palliative care to reduce resource use. Yet, most chemo- and ICI-treatments were administered clearly before the end of life.