Over time, the definition has grown even wider. Now it refers to any treatment effort for people who lose responsiveness or become resistant to even their first treatment regimen. The phrase disturbs many people when applied so widely. People who lose response to a single treatment regimen frequently have a number of options left, including several new drugs and new classes of drugs. These people resent being described as a basket case or at the end of the line.
Salvage usually refers to grasping anything of value from a sunken ship or fire-ravaged building.
It's no wonder people find it inaccurate and offensive. People truly running out of options are by no means in need of salvaging. There isn't much point to creating labels beyond the third line regimen. We encourage writers, educators and physicians to join us in these changes. The new language is less likely to offend and more clearly communicates the concepts involved.