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ASCO: Stepped-Care Model Noninferior to Early Palliative Care for Advanced Cancer

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Fewer palliative care visits seen with stepped-care model, but noninferiority seen in the Functional Assessment of Cancer Therapy-Lung score

By Elana Gotkine HealthDay Reporter

TUESDAY, June 4, 2024 (HealthDay News) — For patients with advanced lung cancer, a stepped-care model with palliative care visits occurring at key points in patients’ cancer trajectory is noninferior to early palliative care, according to a study published online June 2 in the Journal of the American Medical Association to coincide with the annual meeting of the American Society of Clinical Oncology, held from May 31 to June 4 in Chicago.

Jennifer S. Temel, M.D., from Massachusetts General Hospital in Boston, and colleagues examined a stepped-care model to deliver less resource-intensive and more patient-centered palliative care among 507 patients diagnosed with advanced lung cancer. Patients were randomly assigned to either the intervention or early palliative care, including palliative care visits every four weeks. Step 1 of the intervention was an initial palliative care visit within four weeks of enrollment; patients completed a measure of quality of life every six weeks during step 1, and those with a 10-point or greater decrease from baseline were stepped up to meet with a palliative care clinician every four weeks (step 2).

The researchers found that the mean number of palliative care visits by week 24 was 2.4 and 4.7 for stepped palliative care and early palliative care, respectively. At week 24, the Functional Assessment of Cancer Therapy-Lung (FACT-L) score was noninferior for stepped palliative care versus early palliative care (adjusted FACT-L mean score, 100.6 versus 97.8).

“As patients with metastatic cancers are living longer due to improvements in cancer therapeutics, they may have different palliative care needs while living with their cancer versus at the end of life,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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