{"id":2789,"date":"2018-10-17T19:05:54","date_gmt":"2018-10-17T17:05:54","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/raccomandazione-prof\/dont-routinely-use-cancer-directed-therapy-for-solid-tumor-patients-with-low-performance-status-3-or-4-or-progressive-after-2-3-therapeutic-lines-but-prioritize-palliative-care\/"},"modified":"2019-10-02T10:03:42","modified_gmt":"2019-10-02T08:03:42","slug":"dont-routinely-use-cancer-directed-therapy-for-solid-tumor-patients-with-low-performance-status-3-or-4-or-progressive-after-2-3-therapeutic-lines-but-prioritize-palliative-care","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/dont-routinely-use-cancer-directed-therapy-for-solid-tumor-patients-with-low-performance-status-3-or-4-or-progressive-after-2-3-therapeutic-lines-but-prioritize-palliative-care\/","title":{"rendered":"Don\u2019t routinely use cancer-directed therapy for solid tumor patients with low performance status (3 or 4)  or progressive after 2-3 therapeutic lines, but prioritize palliative care."},"content":{"rendered":"<p>The anticancer treatments in general are likely to be ineffective in patients with solid tumors with the following characteristics: low performance status (3-4), no response to previous evidence-based therapies, not eligibility for a clinical trial, the absence of evidence of effectiveness of further treatment. Only exceptions are patients in which the functional limitations are due to non neoplastic pathological conditions resulting in a low PS or patients with disease characteristics (for example, genetic mutations) that suggest a high probability of response to therapy. The choice of avoid anticancer therapies must be sustained by appropriate palliative and supportive therapy (simultaneous care).<\/p>\n","protected":false},"featured_media":2994,"template":"","meta":{"_edit_lock":["1570003334:5"],"_edit_last":["5"],"_wpml_media_duplicate":["0"],"_wpml_media_featured":["0"],"_yst_prominent_words_version":["1"],"_thumbnail_id":["2994"],"_wpml_word_count":["{\"total\":306,\"to_translate\":{\"it\":306}}"],"_yoast_wpseo_primary_eta":[""],"_yoast_wpseo_primary_disciplina":["110"],"_yoast_wpseo_primary_tipologia":[""],"wpcf-pacchetto":["CIPOMO-Green Oncology #1"],"wpcf-bibliografia":["1. Engstrom PF, Benson AB 3rd, Chen YJ, et al: Colon cancer clinical practice guidelines. J Natl Compr Canc Netw    3:468-491, 2005.\r\n2. Smith TJ, Hillner BE: Bending the cost curve in cancer care. N Engl J Med 364:2060-2065, 2011.\r\n3. Peppercorn JM, Smith TJ, Helft PR, et al: American Society of Clinical Oncology statement: Toward individualized care for patients with advanced cancer. J Clin Oncol 29:755-760, 2011.\r\n4. Azzoli CG, Temin S, Aliff T, et al: 2011 focused update of 2009 American Society of Oncology clinical practice guideline update on chemotherapy for stage IV non\u2013small cell lung cancer. J Clin Oncol 29:3825-3831, 2011.\r\n5. McCarthy M. 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