HSD103 Evolution 2019-2020 of Immune Checkpoint Inhibitors (ICI) Administration in Hospitalization at Home (HAH) for Cancer Patients in France: Descriptive Analysis From the French Public Health Insurance Database (PMSI)

ABSTRACT

Objectives: Hospitalization At Home (HAH), facility delivering hospital care at home, constitutes an alternative to hospitalization for ICI infusion. This work aims to describe the evolution of ICI administration in HAH between 2019-2020 in the COVID epidemic context, to characterize patients and their care pathways. Method(s) Through national hospital database (PMSI), all patients with at least one ICI infusion per year, 2019 and 2020 (including Covid-19 lock-down), were identified with a 6-year retrospective chain of all ICI infusion stays. Patients' journey was analyzed (days number before and during HAH period, alternation HAH/ day care unit (DCU) infusion), based on descriptive analysis and treatment sequences clustering algorithms (TAK). Result(s) HAH patients significantly increased from 60 in 2019 to 339 in 2020 but remained limited (0,67% of 2020 ICI patients). Infusions have significantly increased during Covid-19 lock-down periods and remain at a higher level during the rest of 2020. Mean age and gender characteristics tend to be similar (62 and 66 years old, 37% and 33% women). Lung cancer (77% and 64%) and melanoma (23% and 27%) remained the most frequent tumors treated, but head and neck cancers (8%) and renal carcinoma (3%) were newly observed in 2020. Most administered ICIs in 2020 remained nivolumab (49%) and pembrolizumab (41%). In 2020, number of days before HAH was still close to a year (340days) and higher than the days number spent in HAH (n=110). In 2019 and 2020, treatment sequence analysis shows lung cancer patients mainly managed in HAH after first HAH infusion as well as for melanoma in 2019. In 2020, it shows different patterns for melanoma with HAH/DCU alternation dominance after first HAH infusion. Conclusion(s) Despite easier HAH access since Covid-19, HAH remains limited. French Society for Cancer Immunotherapy 2020 recommendations should contribute to HAH development. Copyright © 2022