SPIRE stratified 737 breast cancer patients into low (74.7%), medium (20.0%), and high risk (5.0%) groups, supporting its feasibility for guiding early supportive care.
Does the SPIRE prognostic tool effectively stratify breast cancer patients for early supportive care referral?
The SPIRE prognostic tool is feasible for routine clinical use to stratify breast cancer patients and trigger early palliative care referrals.
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Abstract Background: Early supportive care integration improves quality of life and may enhance survival in patients with advanced breast cancer. However, identifying the right timing and patient subset for such interventions remains a challenge in routine clinical settings. SPIRE (Supportive care patient-level analyses are planned as the dataset matures. Results: Across 1,711 recorded visits between April and June 2025 (representing 737 unique breast cancer patients), 1,279 visits (74.7%) were categorized as low risk, 342 (20.0%) as medium risk, and 85 (5.0%) as high risk. Metastatic disease was present in 946 visits (55.3%), brain metastases in 86 (5.0%), and clinically significant comorbidities in 313 (18.3%). ECOG ≥2 was recorded in 89 visits. Referral to supportive care was documented in 190 visits (11.1%). Follow-up SPIRE score transitions were analyzed in 969 instances. Preliminary trend analysis showed worsening in 131 cases (13.5%) and rapid deterioration (defined as ≥2-point score increase within ≤7 days) in 8 patients. The mean normalized score change was +0.03 (SD ±2.74). These findings support the tool’s dynamic tracking potential, pending formal prospective validation. Conclusions: SPIRE is feasible to implement in routine breast cancer care and effectively stratifies patients based on prognosis and complexity. Its prospective validation will assess real-world prognostic performance, with the goal of enhancing timely and personalized supportive care delivery. Early findings suggest that SPIRE may serve as a valuable clinical trigger for palliative care referrals in breast cancer patients. Citation Format: T. Yordanov, P. Spasov, M. Musin, I. Pandzharova, S. Tuncheva, T. Karanikolova, S. Velchova, A. Konsoulova. Spire-bc: a clinically-integrated prognostic tool to identify breast cancer patients in need of early supportive care abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS1-03-14.
Yordanov et al. (Tue,) reported a other. SPIRE stratified 737 breast cancer patients into low (74.7%), medium (20.0%), and high risk (5.0%) groups, supporting its feasibility for guiding early supportive care.