One of the main goals of palliative care was to lessen the burden of treatment (tx), particularly for cancer patients. When compared to conventional chemotherapies, ARTs were thought to be more well-tolerated and to have a lower toll on the body. Despite this viewpoint, there was minimal data showing EOL results in mPC patients with decreased PS (ECOG >= 2) or arguing for the use of ART.

For a study, researchers conducted retrospective research on 165 patients with mPC who underwent ART at their facility between 2010 and 2021. First, they reviewed each record’s clinical and demographic details, ART regimen, and survival and EOL results. Next, they compared the groups’ overall survival (OS) rates by describing EOL outcomes as the secondary goal. The baseline characteristics were compared using Fischer’s Exact Tests. OS was compared between pts with an ECOG of >= 2 at the beginning of treatment and those with an ECOG of 0 or 1 using Cox regression. To evaluate the results of EOL, descriptive analyses were conducted.

Age at ART initiation was 70.0 years, on average (range 42.0 – 70.0). 13.9% of patients were post-chemo, and 10.3% had an ECOG >= 2. In the ECOG >= 2 groups, the median OS was 8.8 months, whereas, in the less than 2 groups, it was 49.4. (P-value <0.001, HR: 4.58 [2.49 – 8.45]). On univariate survival analysis, variables such as the Charlson comorbidity index, bone metastases, radical prostatectomy, hospitalization, and ADT during treatment were significant (P-value <=.2). ECOG >=2 remained substantially linked with OS on multivariate survival analysis that controlled for various potential confounders (HR: 1.72 [1.28 – 2.31] P-value<.001)

Compared to those with greater PS, patients with mPC and lower PS had shorter OS. Additionally, nearly all patients passed away in the hospital, with those with an ECOG >=2 dying more often. The results underlined the need for enhanced collaborative decision-making in ART treatment and more investigation into the relationship between PS and EOL care.

Reference: annalsofoncology.org/article/S0923-7534(22)03258-6/fulltext