{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:24:16Z","timestamp":1777929856037,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic anticancer therapy (SAT) near the end of life is an indicator of potentially aggressive cancer care. Although patient-level prognostic factors have been studied, the role of treatment escalation within hospital-centered oncology models remains insufficiently understood. This study evaluated late-stage SAT and its determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of 118 patients with metastatic solid tumors who died between March 25, 2020, and April 30, 2025, was analyzed. Receipt of SAT within the last 30 and 14\u00a0days of life was assessed. Multivariable logistic regression identified factors independently associated with SAT in the final 30\u00a0days. Indicators of end-of-life care intensity were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SAT was administered to 42.4% of patients within the last 30\u00a0days of life and to 13.6% within the last 14\u00a0days. A new systemic treatment line was initiated within the final 2\u00a0months of life in 44.1% of patients. Recent treatment escalation was independently associated with therapy use in the last 30\u00a0days (adjusted OR 4.21, 95% CI, 1.89\u20139.38;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), whereas age, performance status, and prior treatment burden were not significant predictors. Median survival from last treatment to death was 40\u00a0days. Overall, 73.7% of patients died in the hospital, and 50% in the intensive care unit (ICU).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recent treatment escalation was the main determinant of exposure to late-stage SAT. High hospitalization and ICU death rates suggest end-of-life care was delivered within a hospital-centered model. Earlier integration of palliative care and structured prognostic communication may better align treatment decisions with patient-centered goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261447487","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T20:00:20Z","timestamp":1777060820000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Anticancer Therapy Near the End of Life: Association of Treatment Escalation With Hospital-Centered Care in Metastatic Cancer: A Retrospective Cohort Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-7972","authenticated-orcid":false,"given":"Ezgi","family":"\u00c7oban","sequence":"first","affiliation":[{"name":"Yeditepe University Faculty of Medicine"},{"name":"Marmara University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Sar\u0131","sequence":"additional","affiliation":[{"name":"Marmara University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serkan","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Yeditepe University Faculty of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bala Ba\u015fak","family":"\u00d6ven","sequence":"additional","affiliation":[{"name":"Yeditepe University Faculty of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-025-00801-x"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2407417"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19323"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.103683"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2024.1129"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102561"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.2378"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.1948"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-12-200106190-00009"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s005200000163"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi061"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyaf066"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2025.105064"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2019.0017"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.4666"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pbj.0000000000000248"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-025-06297-5"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2021.1890332"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.102937"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13215271"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00667"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-018-4457-x"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/08258597241253933"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.40977"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/1472-684X-13-51"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/0825859720946505"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.104099"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.3332\/ecancer.2021.1321"}],"container-title":["American 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