Hospice admission of cancer patients receiving disease-modifying therapies near the end of life: implications for eligibility criteria

PURPOSE: This retrospective single-center observational study aimed to describe our experience of admitting patients based on palliative care needs rather than discontinuation of anticancer treatment. METHODS: The study included all cancer patients admitted to Valerio Grassi Hospice while receiving disease modifying therapies (DMTs) in 2022. Functional status was assessed using the Eastern Cooperative Oncology Group Performance Status (ECOG PS) and the Palliative Prognostic Score (PaP score). RESULTS: Thirty-one of the 150 included patients received DMTs in the last 30 days of life. Among these, five (16.1%) had an ECOG PS 2, 10 (32.3%) ECOG PS 3, and 16 (51.6%) ECOG PS 4. PaP scores were 0-5.5 in three patients (9.7%), 5.6-11 in 14 (45.2%), and 11.1-17.5 in eight (25.8%). CONCLUSIONS: Our findings confirm the ongoing use of DMTs in terminally ill patients and highlight their unmet need for palliative care. Including such patients into hospice programs may help avoid futile aggressive treatments, improve care appropriateness, and ensure better quality of life at the end of life.