2135P - Impact of geriatric assessment (GA) and geriatric 8(G8)-based targeted interventions on the quality of life (QoL) in older Asian adults with cancer

Background

G8 and GA assessments to screen for frailty and facilitate appropriate interventions have been recommended by the International Society for Geriatric Oncology in older adults with cancer. The main objective of this study is to evaluate the impact of G8 and GA-based interventions on the QoL of older Asian adults with cancer.

Methods

This is a prospective study of cancer patients aged ≥70 treated at the National University Cancer Institute, Singapore. The G8, CGA, and EORTC QLQ 30 questionnaires were administered at study entry. Targeted interventions were offered by the multi-disciplinary geriatric oncology (GO) service. After three months, a follow-up EORTC QLQ 30 was repeated for those who required geriatric interventions. Primary outcome measure was comparison of pre/post- EORTC QLQ 30 scores.

Results

N=230 patients were accrued. Median age was 74 (range:70-90). Majority were male (56%), diagnosed with gastrointestinal cancers (35%) and receiving palliative intent treatment (60%). Based on GA, 11% were classified as frail, 58% as pre-frail and 31% as fit. 79% had G8 scores ≤14. Pre-frail, frail and those with G8 ≤14 had lower baseline EORTC QOL function scores and higher EORTC QOL symptom scores (p<0.05). They also had significantly shorter overall survival (OS) compared to fit or with patients G8>14. (HR=2.54 95% CI 1.46-4.43, p=0.001 for frail vs fit patients; HR=1.72 95% CI 1.18-2.53, p=0.005 for pre-frail vs fit patients; HR=1.51 95% CI 1.05-2.18, p=0.027 for G8 ≤14 vs >14). GO interventions were suggested for 144 patients with 104 patients completing a 2^nd EORTC QOL questionnaire. These patients reported significant improvements in the EORTC emotional and social functioning domains (mean difference +4.6, p<0.001 and +12.3 p<0.001, respectively), a significant reduction in the EORTC symptom scale of pain, insomnia, constipation, and financial difficulties (mean difference -5.8 p=0.003, -8.3 p<0.001, -9.0 p<0.001, and -6 p=0.01), with no significant deterioration in other QOL domains.

Conclusions

Geriatric assessment-based targeted interventions delivered by a multidisciplinary GO service significantly improved multiple QOL domains in older Asian adults undergoing cancer treatment.

Clinical trial identification

DSRB Study Reference Number: 2017/00214.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Singapore Cancer Society.

Disclosure

C.E. Chee: Financial Interests, Institutional, Advisory Board: Merck, AstraZeneca, Roche. All other authors have declared no conflicts of interest.