Updates in palliative care of patients with gynecologic malignancies in 2026: early integration, resource models, and emerging therapies

PURPOSE OF REVIEW: This review summarizes recent evidence in palliative care for patients with gynecologic malignancies, focusing on early integration, models of care delivery, and updates in symptom management and palliative procedures. RECENT FINDINGS: Early palliative care involvement, particularly more than 3 months before death, is associated with less aggressive end-of-life care and better alignment with patient preferences. Resource-adapted models, such as stepped approaches and telehealth, expand access to specialist palliative care while preserving quality. Advances in symptom management include olanzapine for cancer anorexia cachexia syndrome, nonopioid analgesics, and cell-free and concentrated ascites reinfusion. Procedural interventions near the end-of-life, such as palliative colostomy for malignant bowel obstruction, highlight the importance of shared decision-making and aligning treatments with patient values, goals, and preferences. Interdisciplinary care models, including nurse-led models such as the BOLSTER trial, further demonstrate benefit in supporting patients and caregivers, and the challenges with illness uncertainty in matching treatments to goals. SUMMARY: Evidence highlights strategies to integrate palliative care earlier, optimize resource use, expand symptom management options, and support patient-centered decision-making in gynecologic oncology.