Timing of final oncologist visit and systemic treatment use near the end of life in pretreated patients with metastatic triple-negative breast cancer: a multinational cohort study

IF 5.2 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2026-02-01 Epub Date: 2026-01-12 DOI:10.1016/j.breast.2026.104699

Justyna Żubrowska , Małgorzata Pieniążek , Anna Polakiewicz-Gilowska , Lenka Rušinová , Renáta Soumarová , Hana Študentová , Aleksandra Konieczna , Agnieszka Młodzińska , Karolina Winsko-Szczęsnowicz , Maja Lisik-Habib , Anika Pękala , Daniel Krejčí , Jan Šustr , Iveta Kolářová , Iwona Danielewicz , Magdalena Szymanik-Resko , Tomasz Ciszewski , Miloš Holánek , Bogumiła Czartoryska-Arłukowicz , Aleksandra Łacko , Mirosława Püsküllüoğlu

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引用次数: 0

Abstract

Background

In heavily pretreated patients with metastatic triple-negative breast cancer (mTNBC), further systemic therapy offers limited benefit and increased toxicity. Recognizing the end-of-life (EOL) phase in time helps avoid overtreatment and ensure goal-concordant care. This study analyzed the interval between the last oncologist visit and death in pretreated women with mTNBC, as well as systemic therapy status, palliative care involvement and related factors.

Methods

This multinational ambispective cohort study included women with mTNBC who received ≥2 lines of palliative systemic therapy and died between June 20, 2022 and June 20, 2025. Data from 17 centers in Poland, the Czech Republic and Slovakia were extracted from medical records. The primary endpoint was the interval between the final oncologist visit and death.

Results

183 women with median age at death 53.6 years (28.6–86.5) were included. Patients had a median of 4 prior palliative chemotherapy lines (2–12) and the median interval from last oncologist visit to death was 17 days (0–410). At the final visit, 29.5 % continued systemic therapy and 49 % had prior palliative care involvement. Longer intervals were associated with PS 0–1 vs ≥ 2 (p = 0.005), while palliative care involvement had no significant effect (p = 0.849).

Conclusions

The results highlight the need for earlier recognition of clinical decline and timely palliative care in mTNBC. Limiting non-beneficial systemic therapy near EOL supports symptom control, autonomy, and quality of life. Despite European efforts, including the Network of Expertise on Complex and Poor Prognosis Cancers, structured EOL planning remains a major gap.

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转移性三阴性乳腺癌患者在临终前接受肿瘤医生最后一次就诊和全身治疗的时机：一项跨国队列研究

背景：在大量预先治疗的转移性三阴性乳腺癌（mTNBC）患者中，进一步的全身治疗提供有限的益处和增加的毒性。及时识别生命末期（EOL）阶段有助于避免过度治疗并确保目标一致的护理。本研究分析了经预处理的mTNBC女性患者最后一次肿瘤医生就诊与死亡之间的时间间隔，以及全身治疗状况、姑息治疗参与情况及相关因素。方法：这项跨国双视角队列研究纳入了在2022年6月20日至2025年6月20日期间接受≥2线姑息性全身治疗的mTNBC女性。来自波兰、捷克共和国和斯洛伐克的17个中心的数据是从医疗记录中提取的。主要终点是最后一次肿瘤科医生访问和死亡之间的时间间隔。结果：纳入183名女性，死亡时中位年龄53.6岁（28.6-86.5岁）。患者既往姑息性化疗的中位数为4次（2-12次），从最后一次肿瘤科医生就诊到死亡的中位数间隔为17天（0-410天）。在最后一次就诊时，29.5%的患者继续接受全身治疗，49%的患者先前接受过姑息治疗。较长的间隔时间与PS 0-1 vs≥2相关（p = 0.005），而参与姑息治疗无显著影响（p = 0.849）。结论：研究结果强调了早期认识mTNBC临床衰退和及时姑息治疗的必要性。在EOL附近限制非有益的全身治疗有助于症状控制、自主和生活质量。尽管欧洲做出了努力，包括复杂和预后不良癌症专家网络，但结构化的EOL规划仍然是一个重大差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.