Researchers have shown the effectiveness of more scalable ways of delivering palliative care in patients with advanced lung cancer, according to new findings published by Temel et al in JAMA and simultaneously presented at the 2024 ASCO Annual Meeting (Abstract 12000).
Background
More intensive treatment for lung cancer is often reserved for those who don’t benefit sufficiently from less intensive care. Stepped palliative care involves the receipt of palliative care but with a minimum of required contact with a specialty-trained clinician.
Previous studies have found that early palliative care—integrated with oncology care from the time of advanced cancer diagnosis—may improve patient and caregiver outcomes. However, this care model has not been widely implemented as a result of the shortage of palliative care clinicians nationwide and challenges in providing palliative care visits throughout the course of cancer treatment, especially as novel cancer therapeutics prolong survival.
Study Methods and Results
In the new study, the researchers randomly assigned 507 patients with advanced lung cancer to receive either stepped or early standard palliative care. The stepped palliative care group received visits occurring only at key points in their cancer trajectories but received more visits after experiencing a decrease in quality of life.
The researchers discovered that stepped palliative care resulted in fewer palliative care visits without diminishing the benefits for the patients’ quality of life.
Conclusions
“To our knowledge, this is the first randomized trial to establish the noninferiority of a palliative care strategy that’s tailored to a patient’s needs by triggering more intensive palliative care services based on patient-reported quality of life compared with resource-intensive early palliative care,” concluded lead study author Jennifer S. Temel, MD, Co-Director of the Cancer Outcomes Research and Education Program as well as Clinical Director of Thoracic Oncology at Massachusetts General Hospital.
Disclosure: The research in this study was supported by the National Cancer Institute. For full disclosures of the study authors, visit jamanetwork.com and meetings.asco.org.