The Role and Timing of Palliative Medicine Consultation for Women With Gynecologic Malignancies

Abstract

The aim of this retrospective study was to investigate the association of palliative medicine consultation with inpatient hospital costs and ACE (aggressiveness of care at the end of life) scores in patients with gynecologic malignancies. Data were obtained from inpatient and outpatient medical records of 100 consecutive patients who died of primary gynecologic malignancies at a single institution. Timely consultation for palliative care was defined as exposure to inpatient consultation for 30 days or more before death. Metrics used to tabulate ACE scores included the following: admission ABSTRACT Standard therapy for platinum-resistant ovarian cancer (OC) is single-agent chemotherapy. The most active single agents are pegylated liposomal doxorubicin, paclitaxel, and topotecan. Use of these single agents has limited benefit, and their use in combination increases toxicity without improving efficacy. Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor, inhibiting development of new blood vessels and cancer growth. This agent has shown activity in OC both as monotherapy and when combined with chemotherapy.AURELIA (Avastin Use in Platinum-Resistant Epithelial OC) is an open-label randomized phase III trial designed to evaluate the efficacy and safety of the combination of bevacizumab and chemotherapy in patients with platinumresistant OC. Eligible participants had measurable/assessable OC that had progressed within 6 months after completing platinum-based therapy. Patients were excluded who had refractory disease or had received more than 2 prior anticancer