Introduction: Few studies assessed, in real life, symptoms, specific interventions and factors influencingpalliative care (PC) initiation for patients with advanced non-small-cell lung cancer (NSCLC). The objective of this study was to examine, in a prospective cohort of advanced NSCLC patients, PC use and factorsassociated with early (≤3 months after diagnosis) PC initiation.

Methods: It was an observational multicenter study. Each center included 10 consecutive patients withPC initiation.

Results: 514 patients were enrolled by 39 centers (age: 62.3 ± 10.7 years, performance status: 0/1; 68.6%cases). At baseline, the most frequent symptoms concerned pain (43.6%), malnutrition (37%) and psycho-logical disorders (25.3%). Specific interventions were infrequent for pain control and malnutrition, butwere more numerous for psychological and social problems and terminal care. Median time betweendiagnosis and PC initiation was 35 [13–84] days, median PC duration was 4.2 [0.6–9.3] months. Medianoverall survival was 8.6 [6.6–10.7] months; median survival after PC initiation was 3.6 [3.2–4.5] months.In multivariate analysis, only PS ≥2 was linked to early PC.

Conclusion: This study showed that early PC initiation is not a standard for patients with advanced NSCLC