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Background and Importance Evaluating the appropriateness of antineoplastic treatment (AT) during end of life care is essential to ensure patient well-being and optimise healthcare resources.Aim and Objectives To describe and analyse the use of AT in oncology patients during their last phase of life.Material and Methods An observational retrospective study was conducted including oncology patients who received AT in 2024 at our centre. Variables collected included demographics (age, sex, ECOG), diagnosis, treatment characteristics (type, intention, line, duration), and mortality-related data (initiation of AT within 30 days prior to death (30DPD), follow-up by the palliative care unit (PCU), emergency or hospital admissions within the 30DPD, cause and place of death, and ongoing AT within 30 or 14 days of death). Descriptive statistics were applied.Results A total of 158 patients (62% male; median age 69 years, IQR 15) were included. The most common diagnoses were lung (29.8%), digestive (24%), and breast (12%) cancer. Treatments received were chemotherapy (70.2%), immunotherapy (22.2%), and targeted therapies (11.4%); 94.3% were administered with palliative intent. PCU follow-up occurred in 54.4% of patients.AT was administered within 30DPD in 25.9% (41/158) and within 14 days in 9.5%. New treatments were initiated within 30DPD in 8.9% of cases, mostly as first-line therapy (65%). ECOG ≥2 was reported in 39% of patients. Median number of treatment cycles was two (IQR 3).The main causes of death were disease progression (93.7%) and infectious complications (3.8%). Emergency visits occurred in 77.2% of patients within 30DPD, with 68.3% requiring hospital admission. Death occurred at home (36.2%), long-term care facilities (40.4%), or hospitals (23.4%).Conclusion and Relevance The proportion of patients receiving AT within 14 days of death (9.5%) was below the 10% threshold described in the literature, but initiation of new treatment within 30DPD (8.9%) exceeded the recommended 2%. These findings highlight possible inappropriate resource use, with high rates of emergency care. PCU follow-up (54.4%) was near optimal (55%). ECOG status and limiting treatment lines may help refine decision making in end of life oncology care.References and/or Acknowledgements 1. DOI: 10.1200/JCO.24.00542;2. DOI: 10.1200/JCO.2004.08.136;3. DOI: 10.1093/jjco/hyn031;4. DOI: 10.3390/cancers15133349Conflict of Interest No conflict of interest