1375P - Predicting chemotherapy toxicity in elderly patients with advanced non-small cell lung cancer: A prospective multicenter study of the national hospital organization in Japan

Background

Previous studies have developed risk stratification schemas to assess chemotherapy toxicity. However, it is controversial which geriatric assessment variables should be used to assess the individual risk of severe toxicity from chemotherapy in elderly patients.

Methods

Patients aged ≥70 years with advanced non-small cell lung cancer (NSCLC) treated at 24 National Hospital Organization institutions completed a pre-1^st-line chemotherapy assessment, including the following: patient characteristics, treatment variables, laboratory test values, and geriatric assessment variables. Patients were followed through one cycle of chemotherapy to assess grade 3 (severe) to grade 5 (death) adverse events according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.

Results

In total, 348 advanced NSCLC patients with a median age of 76 years (range, 70 to 95 years) joined this prospective study. Severe adverse events ≥grade 3 occurred in 136 patients (39.1%). Gender, daily life independence level, and lactate dehydrogenase were associated with non-hematologic toxicity ≥grade 3 in univariate analysis. A scoring system using these predictors distinguished the risk levels of non-hematologic toxicity ≥grade 3; 0 point (6.6%), 1 point (12.2%), 2 point (39.0%), 3 point (75.0%). Predictors of hematologic toxicity were treatment variables, body mass index, body weight loss, and independence of dementia. These predictors provided the predictive model of hematologic toxicity ≥grade 3; 0 point (22.2%), 1 point (33.8%), 2 point (59.6%), ≥3 point (73.3%).

Conclusions

A risk stratification can establish the risk of chemotherapy toxicity in elderly patients with advanced NSCLC.

Clinical trial identification

UMIN000010384, Release date:01APR2013.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

National Hospital Organization.

Disclosure

M. Kanazu: Research grant/Funding (institution): National Hospital Organization. All other authors have declared no conflicts of interest.