Palliative Care

Heterogeneous multimorbidity clusters among Belgian VAD cases and their evolution with age

Analysis of 6,153 Belgian voluntary assisted dying (VAD) cases over 22 years found mean age 83.1 and mean 2.79 comorbid conditions per patient. Five sex-specific multimorbidity clusters emerged: female musculoskeletal, psychiatric and cardiovascular; male cardio-respiratory and neurological profiles. Incidence of VAD for multimorbidity increased over time, especially in the oldest groups, with cluster- and language-region–specific temporal trends. These patterns support individualized end-of-life assessment that integrates cluster-specific burdens rather than single-disease framing. 1

Real-world UK first-line chemoimmunotherapy for oesophago-gastric cancer yields trial-comparable survival

In a retrospective multi-centre UK cohort (n = 76) receiving first-line pembrolizumab- or nivolumab-based chemoimmunotherapy, median overall survival was 16.0 months and median PFS 8.0 months. Disease control occurred in 80.3% and did not differ by tumour site, histology, or agent. Immunotherapy-related adverse events occurred in 40.8% with 13.2% grade ≥3 and two treatment-related deaths. Findings support offering chemoimmunotherapy in eligible patients but mandate early toxicity monitoring and candid risk–benefit discussions. 2

Longitudinal symptom patterns improve prediction of poor HRQoL in childhood cancer survivors

In 576 adult survivors with symptom data over 20 years, adding longitudinal symptom-change patterns improved prediction of suboptimal SF-36 HRQoL. Symptom-enhanced models achieved AUCs 0.75–0.85 versus 0.56–0.66 for models using only demographics and treatment. Sensory symptoms, pain, and anxiety were the most frequent domains and contributed to predictive gains. Regular symptom monitoring in survivorship care can inform targeted interventions and risk stratification for poorer future HRQoL. 3