Clinical utility of the Geriatric-8 in the functional assessment of patients with gynecological cancer aged 75 and older: a retrospective study.

365P - Measures of functional status in adults aged ≥70 years with advanced breast cancer (ABC) receiving palbociclib (PAL) combination therapy in POLARIS

Measures of functional status in older patients treated with palbociclib for advanced breast cancer

G8 screening and health-care use in patients with cancer

The association between baseline frailty and health-related quality of life (HRQOL) in patients with prostate cancer (PC) remains unknown. We retrospectively evaluated the association of pretreatment frailty with HRQOL in 409 patients with PC from February 2017 to April 2020. Frailty and HRQOL were evaluated using the geriatric 8 (G8) screening tool and QLQ-C30 questionnaire, respectively. The primary objective was comparison of G8 and QOL scores between the localized diseases (M0 group) and metastatic castration-sensitive PC (mCSPC group). Secondary objectives were to study the association of G8 and QOL scores in each group and effect of frailty (G8 ≤ 14) on worse QOL. The median age of patients was 70years. There were 369 (surgery: 196, radiotherapy: 156, androgen deprivation therapy alone: 17) patients in the M0 and 40 patients in the mCSPC groups. There was a significant difference between the M0 and mCSPC groups in the G8 score (14.5 vs. 12.5), functioning QOL (94 vs. 87), global QOL (75 vs. 58), and 100-symptom QOL (94 vs. 85) scores. G8 scores were significantly associated with functioning, global, and 100-symptom QOL scores in both M0 and mCSPC groups. The multivariable logistic regression analyses showed that frailty (G8 ≤ 14) was significantly associated with worse global QOL, functioning QOL, and 100-symptom QOL scores. The baseline frailty and HRQOL were significantly different between the localized and metastatic disease. The baseline frailty was significantly associated with worse HRQOL in patients with PC.

BackgroundThe prognostic value of the Geriatric 8 (G8) screening score in metastatic renal cell carcinoma (mRCC) patients receiving first-line immunotherapy remains unclear. This study aimed to evaluate the prognostic role of G8 within the context of the Meet-URO classification in mRCC patients treated with first-line ipilimumab-nivolumab.MethodsThis retrospective multicentre study analysed 106 mRCC patients treated with first-line ipilimumab-nivolumab. G8 and Meet-URO scores were calculated before treatment initiation. Primary endpoint was overall survival (OS), defined as duration from first administration of Nivolumab to death. OS was analysed in relation to age groups, G8 scores, and Meet-URO score categories, with data censored for patients still alive at the last follow-up. The secondary endpoint, progression-free survival (PFS), was measured from initiating Nivolumab to the earliest instance of disease progression or death. OS and PFS were assessed using Kaplan-Meier methods and Cox regression analyses. The reporting of this study conforms to the REMARK guidelines.ResultsPatients with G8 > 14 had more favorable IMDC and Meet-URO risk classifications and lower neutrophil-to-lymphocyte ratios. While PFS did not differ significantly between G8 ≤ 14 and >14 groups (1-year 29.3% vs 46.2%, p = 0.2), OS was significantly longer in G8 > 14 group (1-year 76.1% vs 58.6%, p = 0.006). In multivariable analysis, G8 ≤ 14 was independently associated with worse OS (HR 2.36, 95% CI 1.06-5.08, p = 0.03) but not PFS. The Meet-URO score was prognostic for both PFS and OS. In patients ≥70 years, G8 lost its prognostic value, while Meet-URO remained prognostic for OS.ConclusionsThe G8 score is an independent prognostic factor for OS but not PFS in mRCC patients receiving first-line ipilimumab-nivolumab. The Meet-URO score shows consistent prognostic ability for PFS and OS across age groups. These findings suggest that while G8 may be useful for individual patient-level OS prediction, the Meet-URO score may be superior for guiding treatment decisions in clinical practice.

206 Background: This study aimed to evaluate the geriatric 8 (G8) screening tool for detecting frailty in patients with prostate cancer. Methods: Between January 2017 and June 2019, we prospectively evaluated the G8 in 540 prostate cancer patients, 444 with localized stage M0 and 96 with metastatic stage M1 disease. The primary endpoint was the comparison of G8 scores in patients treated with robot-assisted radical prostatectomy (RARP), radiotherapy, androgen deprivation therapy alone (ADT-alone) for localized disease, and standard care for the M1 disease. Secondary endpoint included the cutoff estimation of G8 score and the influence of G8 on prognosis. Results: The median age was 75 years. G8 scores ≤14 indicating frailty were seen in 36% of RARP (n = 214), 57% of RT (n = 209), 91% of ADT-alone (n = 21), and 70% of M1 disease (n=96). The median G8 score in M0 patients was significantly higher than that in M1 patients (14.5 vs 12.8, respectively). The median G8 score in patients treated with RARP, RT and ADT-alone was 15, 14, and 12, respectively. The patients with RARP had significantly higher G8 score than that of RT or ADT-alone. The optimal G8 cutoff score for patients with M0 and M1 disease was 13.0 (AUC: 0.681). The overall survival was significantly shorter in patients with G8 <13 than that of ≥13. Conclusions: The G8 score of patients with localized and metastatic PC was significantly different. Frailty was significantly associated with treatment selection and prognosis in patients with PC.

Population aging and increased cancer incidence have made the treatment of cancer in older individuals an increasingly important issue. Geriatric 8 (G8) is a screening tool developed to identify patients who would benefit most from a comprehensive geriatric assessment (GA). Previous G8 studies have involved older patients, but the age-related significance and usefulness of G8 is unknown. In this study, G8 screening was administered to patients who were 30years of age or over with cancer to examine a G8 score in each 10years age group and its correlation with other GA tools. The study was conducted at Fukuoka University Hospital from January 2020 to March 2022 and enrolled 715 patients aged ≥ 30years undergoing surgery for primary gastrointestinal cancer or malignant disease. The relationship between age, G8, instrumental activities of daily living (IADL), activities of daily living (ADL), and the Charlson Comorbidity Index (CCI) was investigated. The median age of the patients was 69years (34-98years). Functional disability in ADLs was present in 43 patients (6%) and in IADLs in 72 patients (10.1%). The mean G8 score by age group was 13.7, 13.1, 13.3, 13.3, 12.4, 11.3, and 9.25 for ages 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, and 90-100years, respectively. For each of the ADL/IADL items, the group with functional disability had significantly lower G8 scores than the group without functional disability (p < 0.001). The relationship between the G8 score and CCI by age group showed that the G8 score decreased as the CCI score increased. Assessments divided into age groups of 65, 70, and 75years showed significant differences between groups for most ADL/IADL items and G8 scores, even when divided by age 65. G8 scores were lower in patients with ADL/IADL disabilities and decreased with age in both the presence and absence of disabilities. The G8 total score decreased significantly after the age of 70years. Performing G8 in patients < 65years of age does not decrease sensitivity; however, the functional decline is so slight that it appears reasonable to restrict G8 screening to patients ≥ 65years of age.

Geriatric screening tools in older patients undergoing concurrent chemoradiotherapy for locally advanced non-small cell lung cancer.

e24021 Background: The Geriatric 8 (G8) is a simplified screening tool to select the appropriate elderly patients for chemotherapy. Vulnerable patients with impaired G8 score might need additional comprehensive geriatric assessment (CGA) with intervention for individual problem. However, the impact of CGA and therapeutic intervention on rate of complete chemotherapy among these patients is rarely addressed. This study aims to evaluate the benefit of CGA guided intervention. Methods: A single center, randomized, open-label study which included newly diagnosed elderly cancer patients (age ≥ 65) with impaired G8 score (≤ 14) who were designated for chemotherapy. After the enrollment, patients were randomized to 1:1 ratio to receive CGA guided intervention (intervention group) or usual care (control group). The primary end point was the rate of complete chemotherapy at 90-day. Associated factors for complete chemotherapy were evaluated. Results: Between June 2019 and December 2019, 52 patients were randomized (26 patients for intervention group and 26 patients for control group). Mean age was 72 years, 59.6% was female, 40.4% had breast cancer and 51.9% had early stage cancer. With G8 assessment, 55.8% had intermediate (score 11-14) and 44.2% had low (score &lt; 11) impaired G8 score. All baseline characteristics were balanced. Using per protocol analysis, there was no significant difference in rate of complete chemotherapy between groups (61.9% vs 50%, OR 1.63; 95%Cl 0.51-5.23; p = 0.42). Considering subgroup analysis in the intermediate G8 score patients, the intervention group had a significant higher rate of complete chemotherapy than control group (81.8% vs 66.7%, OR 2.71; p = 0.02), but no significant difference in low G8 score group (40% vs 27.3%, OR 1.78; p = 0.58). In univariate analysis, age below 75 years, BMI &gt; 20 kg/m2 and intermediate G8 score showed significant factors for improving rate of complete chemotherapy. Conclusions: This is the first study in south-east Asia using CGA and intervention to improve rate of completion in chemotherapy. Although the CGA and intervention had no significant difference but had tendency to be better in completion rate of chemotherapy than usual care. The intermediate-impaired G8 score subgroup is more likely to benefit from CGA guided intervention for complete chemotherapy as planned.

e16575 Background: Checkpoint inhibitors (CPI) blocking PD-1 or PD-L1 are a mainstay in the treatment of metastatic urothelial cell carcinoma (mUC). Due to the high bar for clinical trial participation, older patients are underrepresented in trials resulting in FDA-approved therapies that are not always representative of real-world patients. The G8 questionnaire is an 8-question screening tool designed to assess frailty in older adults and alert to the need for geriatric assessment. We investigated the ability of the G8 score to predict clinical outcomes in patients with mUC treated with CPIs. Methods: We performed a retrospective analysis of patients with mUC treated with CPIs in any line of treatment at Winship Cancer Institute between 2016-2019. We collected demographic data, patient and disease characteristics, and immune-related adverse events (irAE). A baseline G8 score was evaluated using past clinic notes from providers, social workers, and dietitians. The G8 incorporates measures assessing food intake, weight loss, mobility, neuropsychological conditions, BMI, polypharmacy, self-assessed health, and age. A score of ≤ 14 suggests potential geriatric vulnerability. Progression-free survival (PFS) and overall survival (OS) were measured from the start of CPI until death or clinical or radiographic progression, respectively. The survival association with the G8 score was analyzed using univariate (UVA) and multivariable (MVA) analyses by the Cox proportional hazard model and Kaplan-Meier method. irAEs association was handled by logistic regression. Results: A total of 48 patients with a median age of 73.5 years were analyzed with 66.7% male 75% white. 70.8% of patients had a baseline G8 suggesting geriatric vulnerability despite 74.4% of patients being scored as having an ECOG score of 0-1. An impaired G8 score at CPI initiation was associated with an increased risk of death but not progression on both UVA and MVA. The association between lower rates of irAEs in patients with impaired G8 scores approached statistical significance (Table). The median OS in Kaplan-Meier analysis for patients with an impaired G8 score was significantly lower (6.8 vs 14 months, p=0.0110) but median PFS was comparable (2.5 vs 3.4 months, p=0.4237) to those with a normal G8. Conclusions: These results indicate that the G8 screening tool may be a useful prognostic tool in mUC patients when planning treatment with a CPI, however should be validated with larger cohort studies. [Table: see text]

AimsTo investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer. Materials and methodsFour hundred and two patients aged ≥65 years (median age 72 years, range 65–96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry. ResultsAfter 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multivariable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2–3.8) for low versus high scores. ConclusionsG8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour.

An exploratory study on the heterogeneity of postoperative delirium: Preoperative cognitive screening does not detect hallucinatory delirium risk

Validation of a screening tool in geriatric oncology: The Oncodage project

Impact of geriatric assessment on the management of older adults with head and neck cancer: A pilot study.

PurposeSelf-care during radiotherapy (RT) is crucial for managing mucositis and dermatitis in patients with head and neck squamous cell carcinomas (HNSCC). However, elderly patients often struggle with self-care. This study examined the relationship between self-care decline and the Geriatric 8 (G8) score.MethodsA retrospective analysis was conducted on 66 patients (≥ 65 years) with HNSCC who met the inclusion and exclusion criteria and received definitive RT between December 2018 and February 2023. Self-care activities—medication adherence, oral care, grooming, skin ointment application, and gauze dressing—were assessed during definitive RT on a 0–5 scale. Patients were first grouped by initial self-care independence, and their G8 scores were compared. Among initially independent patients, those with self-care score changes were further analyzed based on their G8 scores. A threshold value was also determined to differentiate between the groups.ResultsThe initially independent group exhibited significantly higher G8 scores than non-independent group (median G8 score: 14 vs. 9.75, P = 0.0067). Among the initially independent patients, 15 (24.2%) experienced self-care decline, and lower baseline G8 scores significantly predicted this deterioration (median G8 score: 12 vs. 15; P = 0.011). Multivariate analysis identified G8 scores as a significant predictor of self-care decline (odds ratio = 6.53, P = 0.0074). Receiver operating characteristic (ROC) analysis determined a G8 cutoff of 12 (area under the curve = 0.72) with 53.3% sensitivity and 85.1% specificity.ConclusionThese findings indicate a possible coherence between the absence of frailty and maintenance of self-care in elderly patients undergoing RT. Further, prospectively designed research is needed to confirm these findings in a larger cohort.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-025-09936-2.