ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Association between opioid use and treatment discontinuation in patients receiving nivolumab: a real-world database study.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWe evaluated the association between baseline opioid use and time to treatment discontinuation (TTD) in patients receiving nivolumab monotherapy using a nationwide real-world database.
methodsIn this retrospective cohort study using the JMDC database (enrollment: 2015-2020; follow-up through 2022), patients with non-small cell lung, gastric, colorectal, or renal cell carcinoma initiating nivolumab were classified by baseline opioid prescriptions during the 90-day pre-index period. TTD associations were evaluated using multivariable Cox proportional hazards models. Propensity score matching (PSM) and 30- and 90-day landmark analyses were performed as sensitivity analyses.
resultsAmong 1,879 patients (763 opioid users, 1,116 non-users), baseline opioid use was associated with shorter median TTD (112 vs. 284 days; adjusted hazard ratio [aHR], 1.93; 95% CI, 1.68-2.22; P < 0.001). This association remained consistent after PSM (aHR, 1.86; 95% CI, 1.59-2.17) and in landmark analyses. No significant interaction was observed across cancer types (P for interaction = 0.452).
conclusionBaseline opioid use was associated with shorter treatment persistence among patients receiving nivolumab. Baseline opioid use may serve as a pragmatic real-world marker to identify patients at increased risk of early treatment discontinuation who may benefit from closer clinical assessment and supportive care.
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