A survey from a single cancer center found that most patients with metastatic non-small cell lung cancer (mNSCLC) reported unmet care needs and experienced financial hardship. These findings were published in JCO Oncology Practice.

In recent years, immunotherapy or chemoimmunotherapy have become the standard of care for most patients with mNSCLC. However, due to the recent and rapid adoption of these treatments, patient supportive care needs have not been well defined. To better understand the experiences of patients with mNSCLC receiving immunotherapy or chemoimmunotherapy, 60 patients recruited at Markey Cancer Center between 2017 and 2018 were surveyed about demographics, insurance type, evidence of financial hardship, and 34 items of supportive care needs.

Patients were mean age 62.5±9.3 years, 73.3% were White, 38.3% earned less than $25,000 annually, and 50.0% were working full time at the time of diagnosis. The most common treatments were pembrolizumab (75.0%) and chemotherapy (80.0%).

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Most patients (55%) felt they had 1 or more unmet psychological or physical and daily living needs, such as “concerns about worries of those close to me” and “not being able to do things they used to do.”

For financial burdens, 78% reported out-of-pocket medical expenses and 68% reported additional transportation expenses due to their illness. Most patients (52%) indicated they were experiencing hardships in 2 or more domains of psychological, behavioral, or material effects due to medical expenses.

This study was limited in that it could not assess whether unmet care needs and financial burden were an outcome of treatment and not the type of cancer because it did not recruit patients with mNSCLC who were not treated with immunotherapy or chemoimmunotherapy.

The study authors concluded that patients with mNSCLC treated by immunotherapy or chemoimmunotherapy had multiple unmet care needs and many were experiencing financial burden.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


McLouth LE, Nightingale CL, Levine BJ, et al. Unmet care needs and financial hardship in patients with metastatic non–small-cell lung cancer on immunotherapy or chemoimmunotherapy in clinical practice. JCO Oncol Pract. 2021;17(8):e1110-e1119. doi:10.1200/OP.20.00723