464MO - Comprehensive geriatric assessment, patterns of care, and outcome of palliative chemotherapy in elderly patients with advanced solid tumors: A prospective observational study from India

Background

The aging population in India is rapidly increasing, leading to a projected surge in elderly patients with cancer. There is a significant lack of awareness regarding the benefits of comprehensive geriatric assessment (CGA) and a dearth of real-world evidence on how CGA impacts care patterns, correlates with toxicity profiles, and influences survival outcomes, especially among patients exclusively with metastatic solid tumors.

Methods

We conducted a prospective observational study involving 208 patients aged >60 years with advanced solid tumors planned for palliative chemotherapy from June 2022 to December 2023. Screening with the G8 tool was performed for all patients, with those scoring <14 subsequently undergoing CGA. The study aimed to assess care patterns, chemotherapy-related toxicity profiles, correlations with geriatric tools, and progression-free survival (PFS) with first-line chemotherapy.

Results

The mean age of the patients was 68 years, with 202 out of 208 having stage IV solid tumors, predominantly lung cancer (37%). Only 7% of patients had a G8 score >14. The median ECOG PS was 2. Nutritional assessment revealed only 10 patients with normal scores. The median Cancer and Aging Research Group (CARG) score was 9, with 10% scoring 0-5, 48% scoring 6-9, and 41% scoring 10-19. Based on CGA, 16% of patients received supportive care alone, and 65% were offered reduced-dose chemotherapy. ECOG PS, CARG, and G8 were most frequently used for dose adjustments. Sixty-two percent of patients experienced grade 3 or above toxicities, with fatigue (22%) and anemia (11%) being the most common. ROC analysis for CARG score predicting grade 3 toxicity yielded an AUC of 0.574. The median PFS for the cohort was 5 months, increasing to 14 months for patients with G8 >14. Sensitivity of G8 score 12 to predict abnormal CGA was 83.3%.

Conclusions

Although the majority of patients received reduced dose chemotherapy, a significant proportion experienced grade 3 or above toxicities. The G8 score correlated with PFS, and a G8 score of 12 may be considered a cutoff in the Indian population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.