BACKGROUND: Two previous GINECO elderly specific studies in advanced ovarian cancer (AOC) patients highlighted the prognostic value of geriatric covariates for overall survival (OS). PATIENTS AND METHODS: This open-label prospective trial was designed to identify the impact of geriatric covariates on OS in AOC patients ≥70 years treated with first-line carboplatin. RESULTS: Geriatric covariates of the 111 patients included median age 79 years (≥80 years: 41%); performance status (PS) ≥2: 47%; ≥3 major comorbidities: 24%; ≥4 comedications: 68%; activities of daily living (ADL) score <6: 55%; instrumental activities of daily living (IADL) score <25: 69%; Hospital Anxiety and Depression Scale (HADS) >14: 37%. The median OS was 17.4 months. Overall, 74% of patients completed the six planned chemotherapy cycles. Grade 3-4 haematological toxic effects were frequent (50%) but manageable. Grade 3-4 non-haematological toxicities included fatigue (15%), anorexia (12%), infections (9%) and thrombosis (2%). A survival score = exp(0.327*GVS) was developed, where the geriatric vulnerability score (GVS) is the sum of the following (each assigned a value of one): albuminaemia <35 g/l; ADL score <6; IADL score <25; lymphopaenia <1 G/l; and HADS >14. With a cut-off ≥3, GVS discriminated two groups with significantly different OS, treatment completion, severe adverse events and unplanned hospital admissions rates. CONCLUSIONS: The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.
BACKGROUND: Two previous GINECO elderly specific studies in advanced ovarian cancer (AOC) patients highlighted the prognostic value of geriatric covariates for overall survival (OS). PATIENTS AND METHODS: This open-label prospective trial was designed to identify the impact of geriatric covariates on OS in AOC patients ≥70 years treated with first-line carboplatin. RESULTS: Geriatric covariates of the 111 patients included median age 79 years (≥80 years: 41%); performance status (PS) ≥2: 47%; ≥3 major comorbidities: 24%; ≥4 comedications: 68%; activities of daily living (ADL) score <6: 55%; instrumental activities of daily living (IADL) score <25: 69%; Hospital Anxiety and Depression Scale (HADS) >14: 37%. The median OS was 17.4 months. Overall, 74% of patients completed the six planned chemotherapy cycles. Grade 3-4 haematological toxic effects were frequent (50%) but manageable. Grade 3-4 non-haematological toxicities included fatigue (15%), anorexia (12%), infections (9%) and thrombosis (2%). A survival score = exp(0.327*GVS) was developed, where the geriatric vulnerability score (GVS) is the sum of the following (each assigned a value of one): albuminaemia <35 g/l; ADL score <6; IADL score <25; lymphopaenia <1 G/l; and HADS >14. With a cut-off ≥3, GVS discriminated two groups with significantly different OS, treatment completion, severe adverse events and unplanned hospital admissions rates. CONCLUSIONS: The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.
Authors: Vivian E von Gruenigen; Helen Q Huang; Jan H Beumer; Heather A Lankes; William Tew; Thomas Herzog; Arti Hurria; Robert S Mannel; Tina Rizack; Lisa M Landrum; Peter G Rose; Ritu Salani; William H Bradley; Thomas J Rutherford; Robert V Higgins; Angeles Alvarez Secord; Gini Fleming Journal: Gynecol Oncol Date: 2017-01-13 Impact factor: 5.482
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Authors: Sushma Jonna; Leslie Chiang; Jingxia Liu; Maria B Carroll; Kellie Flood; Tanya M Wildes Journal: Support Care Cancer Date: 2016-07-27 Impact factor: 3.603
Authors: Hans Wildiers; Pieter Heeren; Martine Puts; Eva Topinkova; Maryska L G Janssen-Heijnen; Martine Extermann; Claire Falandry; Andrew Artz; Etienne Brain; Giuseppe Colloca; Johan Flamaing; Theodora Karnakis; Cindy Kenis; Riccardo A Audisio; Supriya Mohile; Lazzaro Repetto; Barbara Van Leeuwen; Koen Milisen; Arti Hurria Journal: J Clin Oncol Date: 2014-08-20 Impact factor: 44.544
Authors: Daniel E Lage; Clark DuMontier; Yoojin Lee; Ryan D Nipp; Susan L Mitchell; Jennifer S Temel; Areej El-Jawahri; Sarah D Berry Journal: Cancer Date: 2019-12-20 Impact factor: 6.860