Neoplasms

All Conditions

Respiratory Tract (Lung and Bronchial) Diseases

Carcinoma

Carcinoma, Non-Small-Cell Lung

Lung Neoplasms

Carcinoma, Bronchogenic

Bronchial Neoplasms

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Period of systematic and iterative use of a device for optimizing the decision to continue an anti-cancer treatment.

Patients receiving systemic anticancer treatment in their last days of life

Usual care

Impact of the use of an optimization device of the decision of cancer treatment on aggressiveness of end of life care

Optimization of the medical decision

Marie-Ange MASSIANI, MD

Christine FOULON

Olivier LELEU, MD

Stéphanie MARTINEZ, MD

Claire POULET, MD

José HUREAUX, MD

Nadine PAILLOT, MD

Nicolas CLOAREC, MD

Magali RAVOIRE, MD

Etienne GIROUX-LEPRIEUR, MD

Stéphanie DEHETTE, MD

Marion LOZACH-BRUGIRARD, MD

Ioana CARPIUC, MD

Isabelle MONNET, MD

Aurélie LAGRANGE, MD

Anne-Claire TOFFART, MD

Cyril GUIBERT, MD

Xavier DHALLUIN, MD

Bénédicte MASTROIANNI, MD

Catherine DANIEL, MD

Marie WISLEZ, MD

Valérie GOUNANT, MD

Vincent FALLET, MD

Marie TIERCIN, MD

Anne-Cécile METIVIER, MD

HUET Dimitri, MD

Dimitri HUET, MD

Sequential comparative prospective interventional study evaluating the impact of the use of an optimization device of the decision of cancer treatment on aggressiveness of end of life care. Comparison between a first period, period (A), of care as usual and a second period, period (B), of systematic and iterative use of a device for optimizing the decision to continue an anti-cancer treatment.

We propose to study the optimization of this decision process in an advanced Non-Small-Cell Lung Carcinoma (NSCLC) population, with a Performance Status (PS) ≥ 2 (median survival of approximately 3 months) piloting iteratively (before each decision to continue treatment) a process consisting of an evaluation framework (30 items to be answered by the oncologist with the patient), consolidating:

1. clinical parameters;
2. doctors' expectations regarding the continuation of anticancer treatment;
3. patient expectations and preferences;
4. the possibility of referring the patient to a supportive care specialist and strengthening home care.

The process triggers a dialogue between the patient and the oncologist, based on facts and seeks objectivity, ultimately allowing a shared decision.

In this prospective comparative study, the rate of systemic oncological treatment during the last month of life will be measured consecutively, over a period of usual management, followed by a period of systematic application of a process of optimization of the medical decision.

In this prospective comparative study, the rate of systemic oncological treatment during the last month of life will be measured consecutively, over a period of usual management, followed by a period of systematic application of a process of optimization of the medical decision.

Impact of a Process Optimizing the Decision to Continue or Stop Cancer Treatments in Patients With Advanced Non-small Cell Lung Cancer.

Sponsor will share de-identified data sets Documents generated under the project will be disseminated in accordance with Institut Curie policies.

Comparison of the percentage of patients receiving systemic anticancer treatment in their last 30 days of life during each period

Percentage of chemotherapy (IV, oral) administered in the last 60, 30 and 14 days of life,

Percentage of patients visiting emergency room visits more than once and of unplanned hospitalizations and intensive care admission in the last month of life.

Percentage of initiation of a new line of chemotherapy (IV, oral) in the last month of life

Percentage of immunotherapy and of Tyrosine kinase inhibitor in the last 60, 30 and 14 days of life.

Percentage of initiation of Tyrosine kinase inhibitor or immunotherapy in the last month of life.

Frequency and precocity of use of supportive care.

Overall survival (OS) defined as the time from the date of consent to the date of death due to any cause.

The quality of Life in palliative cancer care patients will be collected with QLQ-C15-PAL EORTC scale and anxiety will be mesured with HAD scale.

Spots Global Cancer Trial Database for optimization device