Mount Sinai-Led Study Suggests Common Cancer Treatment Does Not Work Well for Hospitalized Patients
Immune checkpoint inhibitors (ICIs), a major type of cancer immunotherapy, don’t do much for hospitalized cancer patients, researchers at the Icahn School of Medicine at Mount Sinai report.
Patients to whom ICIs were administered in the hospital had a median survival of only one and a half months following treatment, according to the study, titled “Inpatient Immunotherapy Outcomes Study: A Multicenter Retrospective Analysis.” The first large-scale, multicenter retrospective analysis of inpatient immunotherapy, the study was published earlier this week in Journal of Clinical Oncology: Oncology Practice.
“ICIs are frequently administered to inpatients as a last-ditch effort, despite the lack of robust data supporting their benefit in this setting,” said lead author Deborah Doroshow, MD, PhD, Associate Professor of Medicine (Hematology and Medical Oncology) at The Tisch Cancer Institute at Mount Sinai. “Our study provides clear evidence that most patients do not significantly benefit, and the risks may outweigh the potential rewards.”
Immune checkpoint inhibitors, which help the body’s immune system to recognize and destroy cancer cells and have transformed treatment for many cancer types, are often restricted for inpatient use due to high costs and lack of reimbursement. Single-center studies have previously suggested limited efficacy in hospitalized patients, but this new multicenter analysis reinforces the need for clinicians and health systems to reconsider their use based on poor clinical outcomes.
The research, conducted in collaboration with Stanford, Georgetown, Yale, and the University of Pennsylvania, analyzed data from 215 patients who received ICIs while hospitalized. The findings indicate that 25 percent of these patients died in the hospital, and only 12 percent of patients appeared to benefit from treatment. No significant clinical or demographic factors were associated with a positive response to the therapy. Dr. Doroshow noted that ICIs typically take two to six months to be effective, while many hospitalized cancer patients have life expectancies shorter than that.
These findings could influence hospital policies regarding the administration of ICIs to inpatients. While many health systems already prohibit their use due to financial constraints, this study provides clinical evidence suggesting that inpatient ICI administration should be approached with extreme caution.
“For clinicians, this serves as a reminder that even though we often hope our patient will be the exception, the reality is that very few patients benefit from inpatient ICI therapy,” said Dr. Doroshow. “Families and patients should be aware that, despite the promise of immunotherapy in other settings, the likelihood of meaningful benefit in a hospital setting is very low.”
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the eight- member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,600 clinical residents and fellows training throughout the Health System. Its Graduate School of Biomedical Sciences offers 13 degree-granting programs, conducts innovative basic and translational research, and trains more than 500 postdoctoral research fellows.
Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. More than 4,500 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
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* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Beth Israel; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek’s® “The World’s Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals” and by U.S. News & World Report's® “Best Hospitals” and “Best Children’s Hospitals.” The Mount Sinai Hospital is on the U.S. News & World Report® “Best Hospitals” Honor Roll for 2024-2025.
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