TL;DR: You will routinely play this for 3 or 4 icons and be happy for it.

Don't underestimate this beute. Depending on your investigator, having just 2-3 cards in your hand isn't an unlikely scenario. If this is one of three cards in your hand when played, that means you're getting 3 icons. One of two cards, 4 icons. Last card, 5 icons.

3 icons is by no means bad for a skill card, if a 3 icon "Play only if you have 2 or less other cards in your hand" existed, people would play it. This is that card, and then some.

4 Icons for one card is terrific, and definitely and achievable play once or twice in a scenario.

5 Icons is the golden-egg-laying goose that you think you're picking this card for, but believe me, this is not going to happen a lot.

Wendy and Ashcan, with their card discard mechanics are the obvious optimal character to use this card with, thanks to their innate discard abilities, on the other hand if Last Chance doesn't look playable they can discard it for their abilities.

Last Chance could work with "Ashcan" Pete after Duke ate all his cards. For other investigators, maintaining a healthy hand size is pretty useful toward having options against the menaces that comes up against you. If you have 3 other cards in hand, Unexpected Courage is a much better pick. I cannot imagine investigator wasting his or her limited off-faction card allowance on this.

Nobody in this review section has mentioned that this card is absolutely bonkers on Patrice. Since your goal with her is to include as many cards with pips as possible and use them all on your turn, you will regularly be using this for the full 5 pips. It's especially helpful in dealing with that one guy when he shows up and can otherwise make just about any action you do an anything-but-the-auto-fail.

With her, it synergizes especially well with Cornered. You're going to refill your hand every turn anyway so discard any card you won't use this turn and add another pip to Last Chance.