Our website uses cookies to improve your on-site experience. By using the website, cookies are being used as described in our Policy Document
Warning: To log in you will need to enable cookies and reload the page (Policy Document)
My ePortfolio Register   
 

Abstract | Full HTML Article | PDF ecancer 12 826 / https://doi.org/10.3332/ecancer.2018.826

Short Communication

Cancer treatment in the last 6 months of life: when inaction can outperform action

When an investigational anticancer drug is being tested, demonstration of improvement in overall survival (OS) will generally lead to regulatory approval. However, the value that improvement in OS adds to patients’ lives is guided largely by the context of the improvement and accompanying trade-offs. For example, when a patient’s life expectancy is less than 6 months, many oncologists will not embark on any active cancer treatments. However, multiple new anticancer drugs have been approved recently after being tested in end-stage cancer patients and demonstrating median OS in the experimental arm close to 6 months. Such practice, particularly when the treatment is also accompanied by serious toxicities and cost, can undermine a peaceful life-death transition. In this commentary, we review regulatory approvals in the last 5 years and the ethical considerations involved in testing active cancer treatment in terminal cancer patients.

Keywords: end of life, financial toxicity, overall survival, serious adverse events, fatal adverse events

Loading Article Metrics ... Please wait

Author interviews

Bishal Gyawali

Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

Related videos

Related articles

Review: Women’s cancers: how the discovery of BRCA genes is driving current concepts of cancer biology and therapeutics

Abstract | Full Article | PDF Published: 14 Feb 2019 / https://doi.org/10.3332/ecancer.2019.904

Clinical Study: Plasma neutrophil gelatinase-associated lipocalin and factors related to acute kidney injury and mortality in critically ill cancer patients

Abstract | Full Article | PDF Published: 14 Feb 2019 / https://doi.org/10.3332/ecancer.2019.903

Research: Papillary breast lesions diagnosed by percutaneous needle biopsy: management approach

Abstract | Full Article | PDF Published: 05 Feb 2019 / https://doi.org/10.3332/ecancer.2019.902

Research: Barriers to the non-acceptance of cervical cancer screenings (pap smear test) in women of childbearing age in a rural area of Peru

Abstract | Full Article | PDF | Spanish Published: 31 Jan 2019 / https://doi.org/10.3332/ecancer.2019.901

Research: ROS1 mutation non-small cell lung cancer—access to optimal treatment and outcomes

Abstract | Full Article | PDF Published: 29 Jan 2019 / https://doi.org/10.3332/ecancer.2019.900



Founding partners

European Cancer Organisation European Institute of Oncology

Founding Charities

Foundazione Umberto Veronesi Fondazione IEO Swiss Bridge

Published by

ecancer Global Foundation