1386P - Will ‘Fit’ Older Cancer Patients as Assessed by Frailty Screening Tools Tolerate the First Cycle of (Radio) Chemotherapy Without Serious Adverse Events?

Abstract

ABSTRACT Background There is a need for tools to effectively select elderly cancer patients for therapies with significant potential toxicity such as chemotherapy. The Comprehensive Geriatric Assessment (CGA) is recommended by several guidelines to guide the oncologist in treatment decision making. However, because CGA is time and man-power consuming a two-step approach with screening has been recommended. This pilot study was undertaken to evaluate the predictive value of 2 frailty screening tools in relation to the tolerability of chemotherapy in ‘fit’ older cancer patients. Methods Patients over 65 years with various types and stages of cancer were screened for CGA before start of treatment with the Groningen Frailty Indicator (GFI) and the G8 screening tool. ‘Fit’ patients were defined as having a normal screening test. A G8 score of ≤14 corresponds with an abnormal screening test. For the GFI we evaluated 2 cut-off values. Serious adverse events (SAE) were recorded during the first cycle of treatment. Results From October 2009 to December 2011, 85 patients (44 women) were included in the study. The median age was 76 years old (range: 66-88 years). The treatment intent was curative in 39 patients (46%) and palliative in 46 patients (54%). In total, 15 patients (18%) had a SAE of which 3 resulted in death. According to the GFI, 60% were ‘fit’ while the G8 identified 30% as ‘fit’ prior to treatment. The probability to complete the 1e cycle of chemotherapy without a SAE for ‘fit’ patients was according to the G8 and the GFI (cut-off ≥4) respectively 77% (95%CI: 63-89%) and 78% (95%CI: 73-86%). The alternative cut-off ≥3 for the GFI resulted in probability of 85% (95%CI: 73-94%) to tolerate treatment. Conclusion Patients with a normal screening test for CGA are considered to be able to tolerate proposed treatments comparable to younger patients. However, no data exist concerning this assumption. In this study, we attempted to address this in a heterogenic sample of older cancer patients for 2 screening tools. Further research is needed to compare standard of care with this CGA-based approach with screening. Disclosure All authors have declared no conflicts of interest.