Abstract 1154P
Background
Geriatric assessment (GA) has been advocated for treatment decision in the elderly population which is at high risk of over and under-treatment. However, tumor-specific data are still missing. Our study investigated geriatric predictors of overall survival (OS) and severe chemotherapy related adverse events (CRAEs) in elderly patients treated for metastatic non-small cell lung cancer (mNSCLC) and deemed eligible for chemotherapy.
Methods
We conducted a secondary analysis from ESOGIA phase III trial, which randomized patients with mNSCLC, >70 years, into 2 arms treated either according to an algorithm based on GA or according to a standard evaluation. The present analysis is based on the entire population, who all received a GA, without corrective actions. Main endpoint was 3-months OS, secondary endpoint was CRAEs grade 3 or more of the CTCAE v4.0 classification. Multivariate Cox and logistic models adjusted for time-varying chemotherapy cycle, centers and stratified by randomization arms, were performed.
Results
A total of 493 subjects were included: median age was 77 years, 74.2% were male, 79.6% were former or current smoker, 18.9% had performance status (PS) = 2, 23.9% had comorbidities with Charlson comorbidity index ≥ 2. Three months OS rate was 29.4% [CI 95% 25.2%-34.1%]. The main predictors of 3-months mortality were male gender, altered PS, loss of Instrumental Activities of Daily Living (IADL), altered mobility (Test Get Up and Go), weight loss, anemia, increased CRP/Albumine ratio and LDH. Recent weight loss interacted negatively with IADL score ≤ 6 for 3-months mortality (HR=5.71, CI95% 2.64–12.32). Comorbidities were independently related to more severe CRAEs (OR=1.94 CI 95% 1.06 – 3.56).
Conclusions
In an elderly mNSCLC patients, deemed eligible for chemotherapy, autonomy, mobility and weight loss and combination were independent geriatric factors of early death, while comorbidities were independently associated with CRAES.
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.