ArticleEClinicalMedicine2024
Early palliative care and overall survival in patients with metastatic upper gastrointestinal cancers (EPIC): a multicentre, open-label, randomised controlled phase 3 trial.
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Impact of Early Palliative Care on Overall Survival of Patients With Metastatic Upper Gastrointestinal Cancers, Treated With First-line Chemotherapy: a Randomized Phase III Trial
Benefits of Early Collaboration Between Oncologists and Palliative Care Physicians in Cases of Unplanned Hospitalization for Patients With Metastatic Cancer
Who cites it
8 citing papers in PubMed.
- Effect of early integration of supportive care in addition to standard care in patients with breast cancer: A randomised controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Cancer-Directed Therapy in the Last Month of Life and Its Association With ICU Utilisation in a Tertiary Care Centre in India.Cancer medicine · 2026Article
- The dilemma of perioperative shared decision-making in an octogenarian with advanced cancer: fracture after stent placement and delayed palliative care.BMC palliative care · 2026Article
- Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with Triple Negative Breast Cancer in Both the Early and Metastatic Setting 2025.Current oncology (Toronto, Ont.) · 2026Article
- Patient Characteristics and Different Decision Paths for Establishing Palliative Care for Patients Admitted via the Emergency Department.Journal of clinical medicine · 2025Article
- Development and validation of a prediction score for early identification of palliative care needs for patients in the intensive care unit: a multicentre retrospective cohort study.EClinicalMedicine · 2025Article
- Unusual Manifestations of Primary Pancreatic Neoplasia.Cancers · 2025Review
- Timing Matters: A Systematic Review of Early Versus Delayed Palliative Care in Advanced Cancer.Cancers · 2025Review
Corrections and comments
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Authors and funding
27 authors.
Funding
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Abstract
Background: Early palliative care (EPC) leads to an improvement in quality of life and an unexpected survival benefit compared with oncological care for patients with metastatic lung cancer. The Early Palliative Integrated Care (EPIC) is aimed at examining whether EPC can improve overall survival in patients with metastatic upper gastrointestinal cancer. Methods: We performed a multicentre, open-label, randomised phase-3 trial. Eligible patients were ≥18 years, had metastatic upper gastrointestinal cancer and a performance status of 0-2. Patients from 19 French centres were randomly assigned between 10/10/2016 and 17/12/2021 to receive EPC plus oncological care or standard oncological care (SOC) alone. EPC was provided by palliative care physicians and included five EPC visits scheduled every month, starting within 3 weeks after randomisation. The primary endpoint was overall survival, analysed by intention-to-treat. This study was registered at ClinicalTrials.gov (NCT02853474). Findings: 470 patients were randomised: 233 and 237 patients in the EPC and SOC groups, respectively. In the EPC group, 216/233 patients (92.7%) underwent ≥1EPC visit, with 159 EPC visits per protocol (68.2%). The median follow-up duration was 46 months. We did not observe any overall survival difference between the EPC (median = 7.0 months [95% confidence interval, 6.1-8.8]) and SOC groups (8.6 months [6.8-9.8]) (stratified hazard ratio = 1.04 [0.86-1.26], p = 0.68). No significant heterogeneity was found in primary tumour locations, performance status groups, sex, age groups, and inclusion periods. Interpretation: Our findings suggested that receiving EPC did not improve the benefit of oncological care with regard to overall survival in patients with metastatic upper gastrointestinal cancer. Funding: Programme Hospitalier de Recherche Clinique, Ligue Contre le Cancer, Conseil Régional du Nord-Pas-de-Calais.
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