Supportive Care in Cancer

, Volume 25, Issue 9, pp 2715–2722 | Cite as

A scoring system to guide the decision for a new systemic treatment after at least two lines of palliative chemotherapy for metastatic cancers: a prospective study

  • Brice Chanez
  • François Bertucci
  • Marine Gilabert
  • Anne Madroszyk
  • Frédérique Rousseau
  • Delphine Perrot
  • Patrice Viens
  • Jean-Luc RaoulEmail author
Original Article



A four-parameter score has been identified as associated with overall survival (OS) in patients with advanced cancer with an estimated survival inferior to 6 months. Here, we tested its prognostic value for OS in patients who had received more than two lines of systemic therapy.


We prospectively enrolled patients with advanced cancer who were going to receive a third or more therapeutic line outside classical clinical guidelines. The four parameters (Eastern Cooperative Oncology Group performance status, number of metastatic sites, serum LDH, and serum albumin) were collected at baseline, allowing to calculate the score, which sorted the patients in three groups, A, B, and C (low, intermediate, and high score, respectively). We then searched for correlations between this grouping and clinicopathological features particularly OS.


From August 2013 to March 2014, 65 patients were enrolled and corresponded after determining their score to 26 patients in group A, 30 in B, and 9 in C. The median OS of the cohort was 4.4 months, and the 6-month OS was 42%. Overall survival was different between the three groups, with respective 6-month OS equal to 80% in group A, 17% in group B, and 0% in group C and respective median OS of 9, 2.3, and 1.6 months. Such prognostic value persisted in multivariate analysis. Similar OS differences were observed in patients with PS ≤2.


This simple scoring should help oncologists identify which patients, after at least two lines of systemic therapy, might benefit from best supportive care alone.


Cancer End of life Chemotherapy Prognostic score Supportive care Palliative care 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Brice Chanez
    • 1
  • François Bertucci
    • 1
    • 2
  • Marine Gilabert
    • 1
  • Anne Madroszyk
    • 1
  • Frédérique Rousseau
    • 1
  • Delphine Perrot
    • 1
  • Patrice Viens
    • 1
    • 2
  • Jean-Luc Raoul
    • 1
    Email author
  1. 1.Department of Medical OncologyInstitut Paoli-CalmettesMarseilleFrance
  2. 2.Aix-Marseille UniversityMarseilleFrance

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