'Is it my last Christmas?' Using real-world data as a prompt to reflect on goal-concordant advanced lung cancer care-a retrospective, longitudinal study.

OBJECTIVES: Advanced non-small cell lung cancer (NSCLC) treatment paradigms include prolonged systemic anti-cancer therapy (SACT) courses. Treatment breaks during significant life events may align with patients' care goals but are poorly studied. We evaluated the temporal patterns of palliative SACT received by NSCLC patients during Christmas 2006-2023, a period during which treatment options increased. METHODS: A retrospective, longitudinal study using electronic records examined palliative SACT for NSCLC in the month of December 2006-2023. It was conducted in a hospital designated as a European Society of Medical Oncology Designated Centre of Integrated Oncology and Palliative Care Services. RESULTS: In December 2006-2023, 250 patients with NSCLC received palliative SACT with a mean age of 65.5 years (range: 36-94). Adenocarcinoma constituted 171 cases, and 188 patients were stage IV. During their last Christmas, 53% received palliative SACT (n = 133/250), 4% died within 30 days of treatment (n = 5/133) and 5% spent their last Christmas Eve/Day and/or Boxing Day admitted in hospital (n = 7/133). The proportion of those alive the following Christmas increased over the study period (p < 0.001). CONCLUSIONS: Most advanced NSCLC patients received palliative SACT during their last Christmas, reflecting the need for greater cognisance of goal-concordant care and for studies to provide an evidence basis for treatment breaks.