Abstract 3097
Background
Cancer is a disease of elderly, however data from evidence-based-medicine are missing for therapeutic decision in this population. One of the main issues is to avoid over- and undertreatment situations. Cancer treatment decision in the elderly mainly relies on the Geriatric Assessment (GA) recommended by the International Society of Geriatric Oncology (SIOG). Based on the GA, predictive scores of early death have been developed but they remain difficult to implement in daily oncological practice. In this study, we proposed a simple score with five clinical items to predict 6-month mortality risk in older cancer patients, to guide therapeutic decision.
Methods
A total of 603 patients aged 65 and over were prospectively included in registry in a two-center cohort study that started in November 2013. The whole cohort was divided in a development subset (n = 439), and a validation subset (n = 164) We created a multivariate Cox proportional hazard model with a selection process based on the lowest Akaïke Information Criteria. A beta-coefficient point-based scoring system was used to weight each predictor. Discrimination used the survival Harrel’s C index with 95% CI. Clinical impact was assessed using decision curves.
Results
The mean age was 81.2 ± 6.1 years. Most patients were women and had locally advanced (38%) or metastatic cancers (45%). Colorectal, breast and lung cancers were the most common types. At 6 months, the mortality rate was 17.5%. The score we developed, namely GAIT-SPEED, included five clinical variables: unintentional loss weight of at least 5% of the previous year, slow gait speed < 0.8 m/s, cancer site, cancer extension, and exclusive supportive care decision. We identified 4 increasing risk group (low, medium, high and very-high), ranged from 2% to 61%. The score was well calibrated, and discrimination was good with a Harrel’s C index of 0.75 [0.69-0.81]. Up to 14% of risk of early death, decision curves encourages for a cancer-treatment.
Conclusions
In this study, we developed and validated a simple score easy to implement in daily oncological practice, to predict early death in older cancer patients and guide oncologists in their treatment decision.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Frédéric Pamoukdjian.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2182 - Evaluating the prevalence of the expression of PD-L1 in NSCLC specimens with short-duration formalin fixation using IHC 22C3 pharmDx
Presenter: Keiichi Ota
Session: Poster Display session 1
Resources:
Abstract
5255 - [18F]-FDG PET/CT in predicting PD-L1 status in nasopharyngeal carcinoma
Presenter: Liang Zhao
Session: Poster Display session 1
Resources:
Abstract
4910 - Expression of PD-L1 in Chinese Patients with Common Cancers
Presenter: Min Zheng
Session: Poster Display session 1
Resources:
Abstract
4227 - The clearance of EGF by tumor-associated macrophages is suppressed by chemotherapeutic agent cisplatin
Presenter: Irina Larionova
Session: Poster Display session 1
Resources:
Abstract
5222 - VHIO-300 and a thousand one nights, a tale of Precision Medicine
Presenter: Ginevra Caratù
Session: Poster Display session 1
Resources:
Abstract
5668 - Matched Whole-Genome Sequencing and Whole-Exome Sequencing with Circulating Tumor DNA (ctDNA) Analysis are complementary modalities in clinical practice
Presenter: Robin Imperial
Session: Poster Display session 1
Resources:
Abstract
5772 - Exploring the role of genes associated with familial cancer syndromes on the development of multiple primary tumors
Presenter: Atanaska Mitkova
Session: Poster Display session 1
Resources:
Abstract
4784 - Doxorubicin resistance: early and advanced tumors can use two different strategies based on initial and profound abnormalities in microRNA expression signature
Presenter: Volodymyr Halytskiy
Session: Poster Display session 1
Resources:
Abstract
3456 - From tumor transcriptomes to underlying cell type proportions to better predict prognosis and response to treatments
Presenter: Yuna Blum
Session: Poster Display session 1
Resources:
Abstract
4976 - Optimization of automated germline DNA extraction from non-tumoral formalin-fixed paraffin embedded (FFPE) tissues
Presenter: Omar Youssef
Session: Poster Display session 1
Resources:
Abstract