{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:25:52Z","timestamp":1791314752816,"version":"4.3.1"},"reference-count":36,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Patients with incurable cancers enrolled in early phase clinical trials often face uncertainty about prognosis, yet advance care planning (ACP) is frequently delayed. The objective of this study was to assess the documentation of ACP discussions among patients enrolled in early phase oncology trials. Methods: We conducted a retrospective review of electronic medical records for all adults enrolled in early phase clinical trials at a single Australian institution (2012\u20132021). Data included time from metastatic diagnosis to first ACP discussion, clinical and sociodemographic factors, triggers for discussion, and clinician specialty. Results: Among 170 patients (58% male; median age 65 years), ACP documentation was identified in 109 (64%). ACP was most often initiated within the final year of life (73.8%), with a median interval of 23.5 months from metastatic diagnosis to first documentation. Common triggers were disease progression (39.6%) and hospital admission (37.8%). Discussions were typically led by the treating oncologist or trials specialist (43%) and palliative care physician (37.8%). The most frequently documented topic was the limitations of invasive care such as intubation (60%). Conclusions: ACP documentation was present in two-thirds of patients enrolled in early phase clinical trials, typically late in the disease trajectory. Integrating structured, earlier ACP discussions into oncology pathways would improve alignment of care with patient goals and enhance end-of-life care.<\/jats:p>","DOI":"10.3390\/cancers17223655","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T11:49:43Z","timestamp":1763120983000},"page":"3655","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Documentation of Advance Care Planning in Early Phase Cancer Clinical Trials: An Australian Single-Centre Experience"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0934-614X","authenticated-orcid":false,"given":"Nancy","family":"Huang","sequence":"first","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6919-4865","authenticated-orcid":false,"given":"Joseph","family":"Descallar","sequence":"additional","affiliation":[{"name":"Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia"},{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Vo","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Saint","family":"Lee","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aflah","family":"Roohullah","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Cooper","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Bray","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chua","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia"},{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7711-9718","authenticated-orcid":false,"given":"Danielle","family":"N\u00ed Chr\u00f3in\u00edn","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijit","family":"Pal","sequence":"additional","affiliation":[{"name":"Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia"},{"name":"School of Clinical Medicine, University of New South Wales Sydney, South West Sydney Clinical Campus, Liverpool, NSW 2170, Australia"},{"name":"Liverpool Clinical School, Western Sydney University, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/annonc\/mdx757","article-title":"European Society for Medical Oncology (ESMO) position paper on supportive and palliative care","volume":"29","author":"Jordan","year":"2018","journal-title":"Ann. 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