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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

1891 - Developing a predictive model for chemotherapy related toxicities in older Asian adults.

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Supportive Care and Symptom Management

Presenters

Shien Ling Angela Pang

Citation

Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300

Authors

S.L.A. Pang1, F. Ho2, Y.S. Ng1, C. Cai3, M. Wang3, W.C. Yong4, B.C. Tai5

Author affiliations

  • 1 Haematology Oncology, National University Cancer Institute, Singapore (NCIS), 119228 - Singapore/SG
  • 2 Radiation oncology, National University Cancer Institute, Singapore (NCIS), 119228 - Singapore/SG
  • 3 Yong Loo Lin School Of Medicine, National University of Singapore, 119228 - Singapore/SG
  • 4 Palliative Medicine, National University Cancer Institute, Singapore (NCIS), 119228 - Singapore/SG
  • 5 Saw Swee Hock School Of Public Health, National University of Singapore, 117549 - Singapore/SG
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Resources

Abstract 1891

Background

Elderly patients (pts) are at increased risk of developing chemotherapy (CTx) related toxicities. There are several prediction tools including the Cancer and Aging Research Group (CARG) chemotoxicity calculator (CTC) but this has not been validated in the Asian population. The objective of our study is to identify predictors of G3-5 CTx toxicities and evaluate the utility of the CTC in older Asian adults.

Methods

We enrolled cancer pts aged ≥ 70 years, requiring outpatient treatment with chemotherapy at the National University Cancer Institute, Singapore. A comprehensive geriatric assessment was performed and baseline cancer characteristics, including the 11 variables in the CTC were collected prior to the initiation of CTx. Primary treating oncologists were asked to give an estimated likelihood of CTx related toxicities. Pts were then followed up to 3 months after completion of treatment and CTx toxicities were recorded.

Results

Amongst the 131 pts (mean age: 75 years; range: 70 – 89), their CA diagnoses include colorectal (CRC) (36; 27.5%), lung (27 ; 20.6% ), non-CRC gastrointestinal (17; 13%) , breast (14 ; 10.7%), genitourinary (10 ;7.6%), head and neck (10 ; 7.6%), gynaecological (8; 6.1% ) and other (9; 6.9%) cancers. 54 pts (41%) received CTx with curative intent, and 77 (59%) with palliative intent. The incidence of G3-5 toxicities was 58% (76). The most common toxicities were neutropenia (38 ; 29%) and anaemia (26; 20%) and there was 1 mortality from CTx related pneumonitis. In the multivariable analysis, the factors associated with the incidence of CTx related toxicities were i) Age >72 years, ii) GI/GU cancer, iii) Haemoglobin < 10g/dL (Female) ; <11g/dL (Male), iv) Limited ability to walk 1 block, iv) Limited social support and v) Disease interference with social activity. Based on this new model comprising the above 5 variables, the area under the receiver operating characteristic curve (ROC) is 0.776, whereas that for the CTC and oncologists’ prediction of CTx related toxicities were 0.765 and 0.594 respectively.

Conclusions

Our new model for predicting CTx related toxicities appears to be comparable to the CTC. In our follow up study, we hope to further validate this model’s utility in predicting CTx related toxicities in our elderly cancer population.

Clinical trial identification

Legal entity responsible for the study

Angela Pang.

Funding

National Medical Research Council (Singapore)

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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