Dificulties in the recruitment of patients.

The purpose of this clinical trial is to compare a non-pharmaceutical intervention (Integral Attention Program or PAI) versus standard palliative chemotherapy treatment plus PAI in patients with advanced cancer who have already received at least a first course of chemotherapy but had proven therapeutic failure.

The study hypothesis is that palliative chemotherapy offers no clear benefits in relation to quality-of-life-adjusted survival compared to a comprehensive care program.

Inclusion Criteria:

• Men and women ≥18 years of age.

• Patients potentially eligible to receive a new chemotherapy cycle and whose clinical condition, according to the oncologist, does not identify any therapeutic strategy clearly superior to another, in the light of scientific evidence.

• Patients with advanced cancers that have been treated with chemotherapy but who have not displayed complete response to treatment or who, after treatment response, are now in a situation of recurrence or disease progression

• Patients who have previously received at least one chemotherapy cycle of the following tumors:

  • Cancer of the digestive and gastrointestinal tract
  • Head and Neck Cancer
  • Lung cancer
  • Urologic cancers
  • Gynecologic cancers
  • Central nervous system cancer
  • Melanoma

• Patients who can potentially comply with study and/or monitoring procedures and to accept and sign the informed consent form.

• Patients whose home is located less than 10 km, approximately, of the hospitals participating in the study.

Exclusion Criteria:

• Patients who are currently receiving chemotherapy, although patient pursuing any other concomitant treatment are eligible (eg, hormone therapy or radiation therapy).
• Patients who have contraindications to chemotherapy.
• Patients who did not agree to participate in the clinical trial