{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:54:44Z","timestamp":1791046484400,"version":"4.1.0"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"American Lebanese Syrian Associated Charities"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Children diagnosed with cancer who enroll in phase I clinical trials may be exposed to greater risks beyond drug-related toxicity, such as delays in advance care planning and suboptimal end-of-life (EOL) care. Pediatric palliative care (PPC) can provide a specialized layer of support for patients enrolling in phase I trials; however, little is known about PPC utilization for pediatric phase I participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review of pediatric oncology patients enrolled in phase I trials over a 9-year period was completed at an academic cancer hospital. Data collection included sociodemographic, clinical, PPC, and EOL-related variables. Descriptive analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 539 included participants, central nervous system tumors were the most common diagnosis (44%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 237), followed by leukemias (33%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 179), solid tumors (20%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 108), and lymphomas (3%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 15). Two thirds of patients (68%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 368) had PPC support; however, only 21% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 76) had PPC involvement prior to trial enrollment. Patients with PPC involvement were more likely to die in their preferred location (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), have do not resuscitate documentation (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and enroll in hospice (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). More frequent PPC visits (&gt;20 visits) increased the likelihood of death outside of the ICU (i.e., home or general inpatient floor;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and hospice enrollment (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although most patients enrolled in phase I studies in this review utilized PPC, referrals were typically late in their course. Earlier and systematic PPC integration in this high-risk patient population may offer potential benefits of shared medical decision-making support and optimize EOL care through advanced planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261493731","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:06:55Z","timestamp":1790831215000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative Care Support for Pediatric Cancer Patients Enrolled in Phase I Clinical Trials"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7684-6841","authenticated-orcid":false,"given":"Andrea","family":"Cuviello","sequence":"first","affiliation":[{"name":"Division of Palliative Medicine, Phoenix Children\u2019s, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariela","family":"Trejo","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, New York University, Langone Health, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Zeng","sequence":"additional","affiliation":[{"name":"Division of Quality of Life and Palliative Care, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3206-5648","authenticated-orcid":false,"given":"Deena","family":"Levine","sequence":"additional","affiliation":[{"name":"Division of Quality of Life and Palliative Care, St. Jude Children\u2019s Research Hospital, Memphis, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Spraker-Perlman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology and Palliative Medicine, University of Utah\/Primary Children\u2019s Hospital, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa042220"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019-0615"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732318766513"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08880018.2020.1759738"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/1545-5017.70011"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29230"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26748"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0046"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.0277"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25695"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-022-01239-7"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27771"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/1545-5017.70036"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.07.008"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28363"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30081"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3862"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/nop\/npab020"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2021.0081"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2003-0913-L"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.3938"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.09.001"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24673"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.9.1900"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.32010"},{"key":"e_1_3_2_27_1","unstructured":"26.St. Jude Global: 2018. 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