Purpose: Early phases clinical trials for children with recurrent cancer have recently gone up. For most of these diseases no curative therapy is currently available, thus including the patient in a clinical trial appears to be the only alternative. However, uncertainty regarding the response to treatment remains. The purpose of this study was to evaluate whether a pediatric palliative approach is relevant for these patients.

Material and methods: We have analysed retrospectively the resorting to palliative care teams for 11 children included in a phase II clinical trial designed for recurrent solid tumors.

Results: Only five children had met a palliative care team. Three patients met the palliative care team after getting out of trial and two patients met the team by chance during a pediatric palliative care awareness event. The investigation center not only handled the trial but was also taking care of all the symptomatic treatments. In this context, it seemed difficult for the investigator to address issues around failing health and death, making the use of a palliative care team pivotal to discuss these questions.

Conclusion: It seems to us possible and crucial to include a pediatric palliative approach in patients with recurrent cancer even if included in a clinical trial, whose outcome remains largely uncertain. Further study will need to evaluate the feasibility, the benefit for patients and possible risks of a early recourse to palliative care teams, probably as soon as the inclusion in a clinical trial is considered.