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Invited Commentary
September 2015

Chemotherapy Near the End of Life: First—and Third and Fourth (Line)—Do No Harm

Author Affiliations
  • 1Division of Hematology & Medical Oncology, Knight Cancer Institute & Oregon Health and Science University, Portland
  • 2Palliative Care Service, Oregon Health & Science University, Portland
JAMA Oncol. 2015;1(6):785-786. doi:10.1001/jamaoncol.2015.2379

In reality, only 2 major reasons exist for administering chemotherapy to most patients with metastatic cancer: to help them live longer and/or to help them live better. In exchange for treatment-related toxic effects (as well as substantial time, expense, and inconvenience), chemotherapy can prolong survival for patients with a variety of—though not all—solid tumors. Chemotherapy may also improve quality of life (QOL) for patients by reducing symptoms caused by a malignancy. In this issue of JAMA Oncology, Prigerson and colleagues1 report some troubling trial results: chemotherapy administered to patients with cancer near the end of life achieved neither goal.