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Regina Gironés
Author of
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P2.01 - Advanced NSCLC (ID 618)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:00 - 16:00, Exhibit Hall (Hall B + C)
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P2.01-031 - Use of Geriatric Assessment (GA) in Clinical Practice for Stage IV Non-Small Cell Lung Cancer (NSCLC). The GIDO Experience (ID 9027)
09:00 - 16:00 | Presenting Author(s): Regina Gironés
- Abstract
Background:
Geriatric assessment is strongly recommended to assess the health status of older cancer patients. It can detect multiple health issues, even in patients with good performance status. However, its integration into clinical practice is very slow. In order to engage Medical oncologist on Oncogeriatrics, we developed a prospective protocol to assess GA in clinical practice.
Method:
Elderly patients (> 70 ), stage IV NSCLC wild type, underwent GA. Classified according to GA into fit and medium fi (candidates for antitumoral treatment), and unfit (best supportive care). Data from four teaching hospitals in Comunitat Valenciana (Spain) were entered into a prospective database. The institution’s ethical review board approved the study. Spanish Medicine Agency classified it as a post-authorization study: GIDO-ONC-2015-01. All patients provided written informed consent.
Result:
From 01/2014 to 01/2017, 93 patients with stage IV NSCLC wild type were identified. Median age: 76 (70-92); 30% older than 80 years old. Gender (M/F): 88%/12%. Histology (SCC/AD/NOS): 52%/38%/10%. PS 0-1: 83%. PS was unrelated to GA (p:0.006). 19 PS 0, 10 (52%) were fit, 7 medium-fit (37%) and 2 were frail (11%). PS 1 (57), 47% (27) were fit, 33% (19) medium-fit and 19% (11) frail. Main reasons for medium-fit were comorbidities and dependence in IADL. Frailty patients were those unable for ADL and geriatric syndromes (depression and dementia). GA group was related to overall survival (13 m vs 7,2 m vs 2,2 m,p:0.000) (figure), treatment decision (p:0.0001) and toxicity (p:0.0001). 100% of fit patients were treated with chemotherapy (90%% platinum-combinations), 48% of medium-fit (42% platinum-combinations) and only 8% of frail patients received chemotherapy, none platinum-combinations (p:0.000). Multivariate analysis is pending Figure 1
Conclusion:
Our results suggest that GA identified patients with a poor natural prognosis. Despite generally good performance status, the prevalence of geriatric impairments was high. More research on GA-stratified treatment decisions is needed.
