Abstract 4579
Background
Late lines of therapy (LL) offered to cancer patients (pts) are often characterized by scarce or doubtful clinical benefit and literature evidences about their use and their real impact on survival and quality of life are very few. ESMO-MCBS (ESMO Magnitude of Benefit Scale) is a tool that gives an evaluation of the magnitude of clinically meaningful benefit that can be expected from anti-tumour therapies. The aim of our study was to evaluate ESMO-MCBS of the treatments that were offered as a LL to pts in our centre and to perform an evaluation of the clinical assistance they received.
Methods
We calculated ESMO-MCBS of the therapies that were offered as LL to pts that were treated at our centre and whose death happened in the period from January 1st, 2017 to December 31st, 2018. We also evaluated these pts’rate of unplanned access to emergency room or hospitalizations and their access to supportive care and palliative care service in the last 90 days of their lives.
Results
238 pts were included in the analysis. 12 (5.04%) pts received a LL with a high ESMO-MCBS (4 or 5), 16 (6.72%) a LL with an intermediate ESMO-MCBS, 77 (32.35%) a LL with a low ESMO-MCBS (1 or 2), and 133 (55.88%) a LL whose ESMO-MCBS could not be calculated because of lack of data from strong literature evidences (e.g. phase-3 trials) that are required for the scale. 79 pts (33.19%) had at least an unplanned access to emergency room or hospitalization during the last 90 days before death. 117 pts (49.16%) accessed at least once to our supportive and palliative care service in the same timeframe.
Conclusions
Our study confirmed that patients are often offered a LL whose clinical benefit is little, absent or unevaluable. Merely half of these pts are addressed to supportive/palliative care service whose clinical impact is high in this setting. On the one hand, we then strongly suggest integrating ESMO-MCBS as a clinical tool for the evaluation of possible LL offered to advanced-stage pts in order to prevent them from receiving therapies of poor clinical impact. On the other hand it becomes mandatory to offer these pts a timely access to valuable, more precocious supportive and palliative care, which can positively impact on their quality of life in the last months of their lives.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2182 - Evaluating the prevalence of the expression of PD-L1 in NSCLC specimens with short-duration formalin fixation using IHC 22C3 pharmDx
Presenter: Keiichi Ota
Session: Poster Display session 1
Resources:
Abstract
5255 - [18F]-FDG PET/CT in predicting PD-L1 status in nasopharyngeal carcinoma
Presenter: Liang Zhao
Session: Poster Display session 1
Resources:
Abstract
4910 - Expression of PD-L1 in Chinese Patients with Common Cancers
Presenter: Min Zheng
Session: Poster Display session 1
Resources:
Abstract
4227 - The clearance of EGF by tumor-associated macrophages is suppressed by chemotherapeutic agent cisplatin
Presenter: Irina Larionova
Session: Poster Display session 1
Resources:
Abstract
5222 - VHIO-300 and a thousand one nights, a tale of Precision Medicine
Presenter: Ginevra Caratù
Session: Poster Display session 1
Resources:
Abstract
5668 - Matched Whole-Genome Sequencing and Whole-Exome Sequencing with Circulating Tumor DNA (ctDNA) Analysis are complementary modalities in clinical practice
Presenter: Robin Imperial
Session: Poster Display session 1
Resources:
Abstract
5772 - Exploring the role of genes associated with familial cancer syndromes on the development of multiple primary tumors
Presenter: Atanaska Mitkova
Session: Poster Display session 1
Resources:
Abstract
4784 - Doxorubicin resistance: early and advanced tumors can use two different strategies based on initial and profound abnormalities in microRNA expression signature
Presenter: Volodymyr Halytskiy
Session: Poster Display session 1
Resources:
Abstract
3456 - From tumor transcriptomes to underlying cell type proportions to better predict prognosis and response to treatments
Presenter: Yuna Blum
Session: Poster Display session 1
Resources:
Abstract
4976 - Optimization of automated germline DNA extraction from non-tumoral formalin-fixed paraffin embedded (FFPE) tissues
Presenter: Omar Youssef
Session: Poster Display session 1
Resources:
Abstract