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
3909 - Spectrum of pathogenic germline mutations in Chinese lung cancer patients through next-generation sequencing
Presenter: Ying Huang
Session: Poster Display session 1
Resources:
Abstract
3061 - Poor prognostic impact of NTRK2 gene variation in Esophageal Squamous Cell Carcinoma
Presenter: Ye Chen
Session: Poster Display session 1
Resources:
Abstract
4735 - Mutation profile of Tibetan lung cancer revealed by Whole Exome Sequencing
Presenter: Xin Wang
Session: Poster Display session 1
Resources:
Abstract
5236 - Synergistic activity between niraparib and chemotherapy in colorectal cancer: molecular determinants from a preclinical model
Presenter: Pietro Paolo Vitiello
Session: Poster Display session 1
Resources:
Abstract
4051 - cRGDfK (cRGD) conjugated Pyropheophor¬bide-a (Pyro), a new tumor photodynamic agent, is highly accumulated and specific in tumor cell killing
Presenter: Fengwei Wang
Session: Poster Display session 1
Resources:
Abstract
859 - The expression of MMR, CD133 and the presence of p53 wt predict the response to Cabazitaxel in malignant neural tumors cell lines.
Presenter: Kevin Doello
Session: Poster Display session 1
Resources:
Abstract
2497 - IKS01, a next generation antibody drug conjugate (ADC) designed to be efficacious in tumors with low and moderate levels of folate receptor expression
Presenter: Jenny Thirlway
Session: Poster Display session 1
Resources:
Abstract
1636 - Novel Non-Camptothecin Compounds with Antiproliferative Activities against Breast Cancer Cells
Presenter: Wen-shan Li
Session: Poster Display session 1
Resources:
Abstract
3443 - Sensitization of estrogen receptor-positive breast cancer cells to tamoxifen by novel epi-oligomycin A
Presenter: Margarita Yastrebova
Session: Poster Display session 1
Resources:
Abstract
840 - Autophagy inhibition enhances leflunomide-induced cytotoxicity in human bladder cancer cells
Presenter: Li Cheng
Session: Poster Display session 1
Resources:
Abstract