Frailty assessment predicts toxicity during first cycle chemotherapy for advanced lung cancer regardless of chronologic age

Journal of Geriatric Oncology
Jimmy RuizHeidi D Klepin

Abstract

Improved assessment strategies are needed to individualize treatment for adults of all ages receiving palliative chemotherapy for non-small cell lung cancer (NSCLC). Our aim was to evaluate the utility of the Fried Frailty Index (FFI) and a cancer-specific geriatric assessment (GA) to predict chemotherapy toxicity and overall survival (OS). We conducted a multi-site pilot study of 50 patients with newly diagnosed advanced NSCLC, age ≥ 18 years. All participants received carboplatin AUC 6, paclitaxel 200 mg/m2 every 3 weeks. FFI and the GA were administered prior to chemotherapy. A GA toxicity risk score was calculated. Grade 3-5 toxicity was assessed during 1st two cycles of chemotherapy. OS was measured from chemotherapy initiation. Logistic regression and Cox proportional hazards models were fit to estimate the association between baseline characteristics and toxicity and OS respectively. Among 50 participants, 48 received chemotherapy and were evaluable. The mean age was 68.5 y (range 42-86), 79% male, 85% KPS ≥80. The median OS was 8 months. Many (27%) met FFI criteria for frailty with ≥3 impairments. Impairments detected by the GA were common. In multivariable analyses both FFI ≥ 3 and GA toxicity risk score > 7 were indep...Continue Reading

Citations

Sep 4, 2020·Nature Reviews. Clinical Oncology·Sindhuja KadambiSupriya Mohile
Jan 5, 2021·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Anne-Laure CoudercPatrick Villani
Jan 6, 2021·Current Opinion in Supportive and Palliative Care·Ines B MenjakKristen R Haase
Nov 7, 2020·The Journal of Nutrition, Health & Aging·F M Runzer-ColmenaresJ F Parodi
Oct 25, 2020·Journal of Geriatric Oncology·Anne-Laure CoudercLaurent Greillier
Jul 16, 2020·Clinical Lung Cancer·Anne-Laure CoudercLaurent Greillier
May 19, 2021·European Geriatric Medicine·Anne-Laure CoudercPatrick Villani
Aug 17, 2021·Journal of the National Comprehensive Cancer Network : JNCCN·Pamala A PawloskiBernadette Eichelberger
Jan 16, 2022·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Anne-Laure CoudercPatrick Villani

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