'Best supportive care' has had its day

Abstract

The term 'best supportive care' has been used since 1988 to describe the control arm in trials evaluating chemotherapy in advanced cancers. There are problems with this term. First, it implies that we more strenuously optimise these components of care in trials than in routine oncology practise, when there is no evidence that we do. Secondly, the name implies that it is effective, when usually it is not. Finally, 'best' suggests that we have reached a clear landmark of progress in non-chemotherapeutic palliation, when clearly we have not. 'Best supportive care' is an unhelpful and misleading term which should be avoided. In future trials, it should be replaced by 'standard palliative care ' with the type and frequency of key palliative interventions documented.