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The prevalence of end-of-life chemotherapy and targeted therapy in Japan, assessed using a health claims database

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Abstract

Purpose

This study aimed to investigate the current status of end-of-life chemotherapy and targeted therapy and explore the aggressiveness of end-of-life care in Japan using the DeSC database, a large administrative claims database.

Methods

We identified fatal cases of at least one cancer-related diagnosis between April 2015 and November 2020. Patients prescribed at least one anticancer drug were analyzed, and chemotherapy regimens were categorized based on the combination of concomitant anticancer drugs prescribed.

Results

Among 1,095,713 individuals enrolled in the National Health Insurance database, 7,300 deaths with cancer-related diagnosis were identified. Of these, 4,010 cases were identified in which at least one anticancer drug was prescribed, and 11.6% of 7,300 death had been prescribed anticancer drugs in their last 30 days of life. The most commonly used regimen was S-1 (tegafur, gimeracil, and oteracil potassium combination) monotherapy, followed by nivolumab monotherapy and nab-paclitaxel plus gemcitabine. Immune checkpoint inhibitor monotherapy was more likely prescribed to patients whose last chemotherapy dose was in the last 30 days of life (p = 0.0066, chi-squared test).

Conclusions

This study provides insights into the current status of end-of-life chemotherapy and targeted therapy in Japan, using a large administrative claims database. The results of this study will inform future research on end-of-life chemotherapy and targeted therapy, and help develop strategies to improve the quality of life of patients with advanced cancer.

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Data availability

The data that support the findings of this study are available from DeSC Healthcare, Inc., but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.

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Acknowledgements

We would like to thank DeSC Healthcare, Inc., and all those who work for them. The database used in this study was provided by DeSC Healthcare, Inc., as part of their academic research support program. We also would like to thank Editage (www.editage.com) for English language editing. This work was supported in part by a Grant-in-Aid from Kurokawa Cancer Research Foundation.

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Authors and Affiliations

  1. Department of Pharmacy, Miyagi Cancer Center, 47-1 Nodayama, Medeshimashiote, Natori, Miyagi, 981-1293, Japan

    Masami Tsuchiya

  2. Laboratory of Biomolecule and Pathophysiological Chemistry, Graduate School of Pharmaceutical Sciences, Tohoku University, 1-1, Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Masami Tsuchiya & Nariyasu Mano

  3. Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Taku Obara, Masafumi Kikuchi & Nariyasu Mano

  4. Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan

    Taku Obara

  5. Pharmacy Education and Research Center, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai, 980-8578, Japan

    Masafumi Kikuchi

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  1. Masami Tsuchiya
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Correspondence to Masami Tsuchiya.

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Tsuchiya, M., Obara, T., Kikuchi, M. et al. The prevalence of end-of-life chemotherapy and targeted therapy in Japan, assessed using a health claims database. Cancer Chemother Pharmacol 91, 501–506 (2023). https://doi.org/10.1007/s00280-023-04535-6

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  • DOI: https://doi.org/10.1007/s00280-023-04535-6

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