Prognostic understanding and barriers to palliative care in patients with metastatic lung cancer on immunotherapy.

36Background: Communicating prognosis and integrating palliative care (PC) are challenging yet vital aspects of quality care for patients with metastatic non-small cell lung cancer (NSCLC). These tasks may be more difficult in the setting of immunotherapy, as this modality may offer a durable response but only in 10-20% of patients. Our goal was to identify correlates of prognostic understanding and interest in PC among stage IV NSCLC patients receiving immunotherapy. Methods: We conducted a cross-sectional survey of 60 patients (M age = 62.5 years; SD = 9.3 years; 40% male; 45% ≤ high school degree; 68% ECOG ≤ 1) undergoing immuno- or chemo-immunotherapy for stage IV NSCLC (80% de novo) at an academic medical center. Results: Most patients (73%) reported that knowing their prognosis was very important. Nearly all said the goal of treatment was to help them live longer (98%), feel better (95%), and completely rid them of cancer (85%); 49% thought they were likely to be cured. Only 17% of patients were int...