PUB068 The Applicability of Comorbidity Indices in Predicting Chemo toxicity in Non-Small Cell Lung Cancer

Abstract

Lung cancer is one of the commonest cancer worldwide contributing to 13% of the total number of cancers.1 It is the leading cause of cancer related death in the United Kingdom with poor 10 year survival rate of 5%.2 Advanced age and the presence of comorbid conditions are associated with poor survival rate. The use of Platinum based chemotherapy in advanced non-small cell lung cancer (NSCLC) has improved survival rate and improve the quality of life. However, these effects are limited by the chemotherapy induced toxicity. Prior to commencement of chemotherapy, there is no current method which can be used to predict the development of unacceptable level of chemo-toxicity that might subsequently result in reducing or stopping the chemotherapy treatment. This study aims to correlate platinum-based chemotherapy haematological and non-haematological toxicities in patients with NSCLC against two commonly used comorbidity indices namely Charlson Comorbidity Index (CCI) and the Adult comorbidity Evaluation 27 (ACE 27). Case note review for patients with cytologically or histologically confirmed NSCLC, aged between 18 and 85 with a World Health Organisation performance status (WHO PS) of < 2, eligible for platinum based chemotherapy and have a life expectancy > 3months. Exclusion criteria include the presence of an active infection and those who received platinum- based chemotherapy previously. Patients were identified from the combined lung cancer clinics and multidisciplinary meetings and were invited to participate in the study. Baseline demographic data (age, sex, PS, cancer stage and type) was obtained. CCI and ACE 27 tools were used to score baseline comorbid conditions for each patient with and without the inclusion of the disease. After each chemotherapy cycle, haematological and non-haematological toxicity data was 61 cases were identified, 10 were excluded from final analysis due to change of diagnosis or missing consent form. The median age at diagnosis was 68 years (range 45-85year). 57% were men. Most patients had WHO PS of 1, diagnosis of adenocarcinoma and had stage VI cancer. 67% of patients developed severe toxicities (grade 3 or above). There was no correlation between higher comorbidity scores (ACE≥2 & CCI ≥ 3) and risk of severe toxicities (p >0.005). The presence of comorbid conditions was not associated with severe chemotherapy- induced toxicity.