2114P - Impact of comprehensive geriatric assessment (CGA) in the management of chemotherapy toxicity in older cancer patients

Background

Up to 90% of elderly patients (pts) develop toxicity when treated with chemotherapy (CT). This can often lead to dose reductions, temporary or even definitive treatment interruptions. The CGA is a useful tool to detect frailty, and to predict and prevent unnecessary toxicities. We wanted to explore the effect of CGA in improving tolerance to CT in daily clinical practice of elderly pts with gastrointestinal tumors.

Methods

Observational retrospective study of a cohort of digestive tract cancer pts > 70 years old treated between 2016 and 2023 at Hospital del Mar, Barcelona (Spain), comparing CT tolerance of those receiving CGA with those without CGA. CGA was performed by an oncogeriatrician following the recommendation of the oncology interdisciplinary tumor board. We analysed toxicity, polypharmacy and predict the toxicity risk with CT using CARG score.

Results

One-hundred and eighty pts were included: 58% colorectal, 32% pancreatic, 6% bile duct and 4% gastric cancers. 91 of them (51%) received CGA. Median age was 79 (CGA group) vs 74 (non-CGA group) years old. ECOG PS was 0-1 in 87% of the CGA group and in 94% of the non-CGA. In the CGA group, 63% received CT in the unresectable/metastatic setting vs 52% in the non-CGA group. Polypharmacy (>4 drugs) was present in 60% of CGA group (median of 7 drugs per patient) vs 68% of non-CGA (median 6 drugs). The CARG toxicity risk score was low in 34% of pts, intermediate in 55% and high in 11%. CT treatment was initially adapted in 38 pts (43%) of the non-CGA group vs 55 pts (60%) in the CGA group. High-grade (3-4) toxicities were more frequent in the non-CGA (32% pts) compared to CGA (24% pts). More pts in the non-CGA group needed dose reductions during treatment (62%) compared to the CGA group (43%), with statistical significance (p=0.009). Table: 2114P

Conclusions

Performing CGA helps to prevent high-grade toxicity in elderly pts with digestive tract tumors by adapting CT treatment and reduces CT dose reductions related to toxicities.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Guix Arnau: Financial Interests, Personal, Invited Speaker: BMS, Astellas, Merck, Sanofi, Roche, Kyowa-Kirin, MSD. All other authors have declared no conflicts of interest.