Gerontology & Geriatric Research

Predictive factors for chemotherapy feasibility in elderly patients with solid tumour with a focus on colorectal cancer: Results of the GERCOR old prospective multicenter study

International Conference on Geriatrics & Gerontology

July 08-10, 2014 DoubleTree by Hilton Hotel Chicago-North Shore Conference Center, USA

E Carola , B Chibaudel , Stephanie Trager, Le?la Bengrine-Lef?vre, Joelle Chuzel, Jean Francois Seitz, Patrick Dion, Pascal Artru, Nasredine Aissat, Emmanuelle Sarlon, Florence Woerth, M?lanie Gauthier, Franck Bonnetain and Aimery de Gramont K

Accepted Abstracts: J Gerontol Geriat Res

Abstract:

Introduction: One quarter of patients with cancer are 75 years old and above. Previous studies have suggested that taking into account selected geriatric parameters extracted from the comprehensive geriatric assessment may improve both prognosis and chemotherapy tolerance. However they were heterogeneous consisting of patients with different tumour types and treatment regimens. A simplified scale would be a helpful tool for oncologist to predict chemotherapy feasibility. Objectives: The aim of the prospective OLD cohort study was to identify geriatric predictors of chemotherapy feasibility in chemo-na?ve elderly cancer patients (NCT00664911). Methods: Inclusion criteria: ≥75 years, solid tumour, patient planned to receive ≥2/3 of standard dose of first cycle of standard chemotherapy. Ten selected geriatric parameters were recorded at baseline by the oncologist: 1. 3 words test, 2. date and address (cognitive function), 3. instrumental activities of daily living, 4. monopodal stand-up test, 5. hospitalization during previous year, 6. number of medicines taken for co morbidities, 7. creatinine clearance, 8. albumin serum level, 9. self-rated depressive mood and 10. presence of a caregiver. The main outcome was chemotherapy feasibility defined by the ability to deliver at least 3 months of the planned regimen therapy, using a multivariate logistic regression Results: From 2008 to 2012, 576 patients were included in 49 centers. 516 (89.6%) were eligible for analysis. Patients? characteristics: mean age 81 years; main tumour type, colorectal (51%); advanced stage, 70%; PS 0-1, 84%. Chemotherapy feasibility as defined per protocol was reached in 298 (57.8%) patients. Grade 3-4 toxicity occurred in 26.2%. In multivariate analysis, only 2 factors were significantly associated with failure to deliver chemotherapy: albuminemia < 30 g/L (adjusted OR =2.34 CI95% [1.43-3.83]) and depressive mood (adjusted OR=1.55 CI95% [1.02-2.35]). Conclusion: Albuminemia and self rated depressive mood status are independent predictive factors for chemotherapy feasibility in elderly patients with solid tumour adding question to the relevant selection of geriatric factors to be used in the baseline assessment before chemotherapy administration. A focus on the colorectal subgroup will be presented at the meeting.