TY - JOUR
T1 - Systemic Anticancer Treatment Near the End of Life
T2 - a Narrative Literature Review
AU - Geyer, Teresa
AU - Le, Nguyen-Son
AU - Groissenberger, Iris
AU - Jutz, Franziska
AU - Tschurlovich, Lisa
AU - Kreye, Gudrun
N1 - Funding Information:
We acknowledge the support in terms of publication fees and fees for proofreading by a native speaker to the Karl Landsteiner University of Health Sciences, Krems, Austria. We acknowledge the support for this study by a Seed Funding Grant, SF42 (Ktr. 500330041), from the Karl Landsteiner University of Health Sciences, Krems, Austria.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/7/27
Y1 - 2023/7/27
N2 - Systemic anticancer therapy (SACT) includes different treatment modalities that can be effective in treating cancer. However, in the case of disease progression, cancers might become incurable and SACT might reach its limits. In the case of incurable cancers, SACT is often given in a palliative setting, with the goal of improving the patients' quality of life (QOL) and their survival. In contrast, especially for patients who approach end of life (EOL), such treatments might do more harm than good. Patients receiving EOL anticancer treatments often experience belated palliative care referrals. The use of systemic chemotherapy in patients with advanced cancer and poor prognosis approaching the EOL has been associated with significant toxicity and worse QOL compared to best supportive care. Therefore, the American Society of Clinical Oncology (ASCO) has discouraged this practice, and it is considered a metric of low-value care by Choosing Wisely (Schnipper et al. in J Clin Oncol 4;30(14):1715-24). Recommendations of the European Society for Medical Oncology (ESMO) suggest that especially chemotherapy and immunotherapy should be avoided in the last few weeks of the patients' lives. In this narrative review, we screened the current literature for the impact of SACT and factors predicting the use of SACT near the EOL with discussion on this topic.
AB - Systemic anticancer therapy (SACT) includes different treatment modalities that can be effective in treating cancer. However, in the case of disease progression, cancers might become incurable and SACT might reach its limits. In the case of incurable cancers, SACT is often given in a palliative setting, with the goal of improving the patients' quality of life (QOL) and their survival. In contrast, especially for patients who approach end of life (EOL), such treatments might do more harm than good. Patients receiving EOL anticancer treatments often experience belated palliative care referrals. The use of systemic chemotherapy in patients with advanced cancer and poor prognosis approaching the EOL has been associated with significant toxicity and worse QOL compared to best supportive care. Therefore, the American Society of Clinical Oncology (ASCO) has discouraged this practice, and it is considered a metric of low-value care by Choosing Wisely (Schnipper et al. in J Clin Oncol 4;30(14):1715-24). Recommendations of the European Society for Medical Oncology (ESMO) suggest that especially chemotherapy and immunotherapy should be avoided in the last few weeks of the patients' lives. In this narrative review, we screened the current literature for the impact of SACT and factors predicting the use of SACT near the EOL with discussion on this topic.
UR - http://www.scopus.com/inward/record.url?scp=85165905415&partnerID=8YFLogxK
U2 - 10.1007/s11864-023-01115-x
DO - 10.1007/s11864-023-01115-x
M3 - Review article
C2 - 37501037
SN - 1527-2729
JO - Current Treatment Options in Oncology
JF - Current Treatment Options in Oncology
ER -