What does this research mean for the field?

SPIRE effectively stratified 737 breast cancer patients into low (74.7%), medium (20.0%), and high risk (5.0%) categories for supportive care recommendations. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to validate the SPIRE prognostic tool for early supportive care intervention in advanced breast cancer patients.

February 19, 2026

Abstract PS1-03-14: Spire-bc: a clinically-integrated prognostic tool to identify breast cancer patients in need of early supportive care

Key Result

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.

Key Points

This research aims to validate the SPIRE prognostic tool for early supportive care intervention in advanced breast cancer patients.
Subgroup analysis of breast cancer patients within a prospective SPIRE implementation.
Integration of clinician judgment and clinical variables to stratify risk.
Tracking patient referrals to supportive care and follow-up status over designated time points.
Prospective validation strategy planned with time-based cutoffs for assessing mortality prediction.
1,711 recorded visits categorized patients into risk groups: 74.7% low risk, 20.0% medium risk, and 5.0% high risk.
55.3% of visits involved metastatic disease, with a notable presence of comorbidities in 18.3% of visits.
Referral to supportive care documented in 11.1% of visits with potential drastic changes in SPIRE scores observed.

Structured PICO

Does the SPIRE prognostic tool effectively stratify breast cancer patients for early supportive care referral?

Population

737 unique breast cancer patients (1,711 recorded visits) at a medical oncology clinic

Intervention

SPIRE (Supportive care & Prognostic Insights in Risk Evaluation) prognostic tool

Outcome

Risk stratification category (low, medium, high) and referral to supportive care

The SPIRE prognostic tool is feasible for routine clinical use to stratify breast cancer patients and trigger early palliative care referrals.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

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.

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