Prognosis of the critically ill cancer patient in the era of precision oncology

Abstract

The prognosis of critically ill patients with cancer has changed significantly in the era of precision oncology. Advances in organ support, timely ICU admission, and the availability of targeted therapies and immunotherapy have improved survival in many settings, with an increasing number of patients able to resume their oncologic treatment. However, predicting individual outcomes remains challenging, as traditional models do not capture the biological complexity or clinical heterogeneity of cancer. Factors such as functional status, reversibility of the acute event, presence of organ failure, and the molecular characteristics of the tumor have emerged as important prognostic determinants. Additionally, the microbiome is recognized as a critical modulator of immune responses, influencing susceptibility to infections and contributing to carcinogenesis. Integrating these elements is essential to advance toward more accurate prognostication in critically ill oncology patients.