(ChemotherapyAdvisor) – Patients with metastatic non–small-cell lung cancer (NSCLC) should be offered concurrent palliative and standard oncologic care at initial diagnosis, the American Society of Clinical Oncology (ASCO) recommended in a provisional clinical opinion published in the Journal of Clinical Oncology online February 6.

While the evidence is strongest for metastatic lung cancer, “combined standard oncology care and palliative care should be considered early in the course of illness for any patient with metastatic cancer and/or high symptom burden,” the opinion states.

ASCO convened a panel of oncology and palliative experts, who developed the new evidence-based clinical guidance, “The Integration of Palliative Care into Standard Oncology Care,” based on data from seven recently published randomized clinical trials. These trials included patients with metastatic cancer who received either standard care or both standard and concurrent palliative care.


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In 2010, a Phase 3 randomized study found that patients with metastatic NSCLC who received early concurrent palliative care had significant improvements in both quality of life and mood as well as less aggressive care at the end of life and longer survival compared with those receiving standard oncologic care alone. It was these results that prompted a review of the evidence that led to this opinion.

“Strategies to optimize concurrent palliative care and standard oncology care, with evaluation of its impact on important patient and caregiver outcomes (eg, QOL, survival, health care services utilization, and costs) and on society, should be an area of intense research,” the authors wrote.

Abstract

Article, NEJM