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A B S T R A C T S
S79
care, anticancer treatments and outcome (functional, QoL,
cancer, survival) in NHR. Eligibility criteria were patients
with a new cancer event (new cancer or progressive disease
of a previously known cancer) where a diagnostic/treatment
decision has to be/has been taken ; and patients with strong
clinical suspicion (physician’s judgement) of a new cancer
event (new cancer or progressive disease), but where the
decision is made not to take further diagnostic or therapeutic
steps. Eligible patients were recruited during a period of 1 year
in these 39 nursing homes. After training each site’s local
staff, identified eligible patients were included after informed
consent, and relevant data, including a questionnaire for the
nursing home physician, were collected at baseline. Cancer
evolution, geriatric assessment, QoL, and advance care
planning were evaluated at least every 3 months up to 2 years.
Results:
The study was open from 3-2015 till 3-2016 in
37 nursing homes (and 2 pilot nursing homes started and
stopped 6 months earlier). In only 9 NHR, a cancer event was
recorded during this period. Median age was 87y (72-92), 3
male/6 female. Further details on cancer type, diagnostic and
therapeutic approach and outcome will be reported at the
meeting.
Conclusion:
Clinically relevant cancer events (requiring
diagnostic or therapeutic action) occur at a much lower
frequency in NHR than expected from cancer incidence data
in the general population.The prospective design with intense
involvement from the key responsibles in each nursing home,
makes significant underreporting of cancer events unlikely.
Disclosure of interest:
None declared
Keywords:
Nursing home
P073
CLINICAL BENEFIT RATE AND PARTICIPATION OF PATIENTS
WITH ADVANCED CANCER ON PHASE I CLINICAL TRIALS:
A COMPARATIVE ANALYSIS OF SENIOR ADULTS AGED
65 YEARS AND ABOVE VERSUS MIDDLE AGE AND AYA
PATIENTS
I. M. Subbiah
1,
*, C. Tang
1
, A. Rao
1
, V. Subbiah
1
, R. Kurzrock
2
,
D. Karp
1
, D. S. Hong
1
1
University OF Texas MD Anderson Cancer Center, Houston,
2
University of California San Diego Moores Cancer Center, San
Diego, USA
Introduction:
Senior adults aged 65 years and above with
advanced cancers remain underrepresented in cancer clinical
trials particularly early phase clinical trials of novel therapeutics.
Objectives:
To assess the participation and clinical
response of senior adults on phase I treatment, we analyzed
the characteristics of such patients treated on phase I trials
with an emphasis on comparison between middle age and
adolescent/young adults (AYA) patients.
Methods:
A prospectively maintained database was
queried to identify 1489 consecutive patients treated on
phase I trials between December 2004 and July 2013. The
patients were separated into 3 age-based cohorts: AYA (15-
39y), middle age (40-64y), elderly (65+y) and analyzed for
clinical characteristics and response outcomes as defined
by each clinical trial per RECIST. The clinical benefit (defined
as a response of stable disease of 6 months or longer, partial
response, or complete response, per RECIST) was determined
for each cohort. We calculated the odds ratios of achieving a
favorable clinical benefit for the 3 age cohorts, and for elderly
and AYA in comparison to the middle age.
Results:
Of 1489 treated patients, 278 were elderly (18%,
median age 68.9y), 220 AYA (15%, median age 32.6y), 991
middle age (67%, median age 53.8y). The median number of
prior therapies was 3 in all three age groups and the most
common malignancies were gastrointestinal (n=438, 29%),
gynecologic (n=234, 16%), and thoracic/head/neck (n=216,
15%). There was no standarized assessment of performance
status and frailty beyond the ECOG PS. Median time on trial
did not vary significantly between the 3 age cohorts (3 months
in elderly, 3.5 months in middle age, 3.3 months in AYA). The
odds ratio of achieving clinical benefit in elderly vs middle
age is 1.10, p 0.19 (two-tailed), p 0.09 (one-tailed). Similarly,
the odds ratio of achieving clinical benefit in AYA vs middle
age is 0.85, p 0.31 (proportions z-test, two tailed), p 0.15 (one-
tailed). No significant differences were found in the odds ratio
of response between the elderly, AYA and middle age cohorts.
Conclusion:
Elderly patients accounted for less than 20% of
patients on phase I clinical trials but those who participated
were just as likely to achieve a clinical benefit as the AYA and
middle age patients. Participation in phase I therapy may
offer a reasonable therapeutic option for elderly patients with
advanced cancers.
Disclosure of interest:
None declared
Keywords:
Clinical trial participation, phase I clinical trial
P074
EPIDURAL BASED ANESTHESIA FOR FRAIL ELDERLY
PATIENTS IN BREAST CANCER SURGERY: METHOD OF
CHOICE?
J. Wallage
1,2,
*, H. Harbers
2
, I. den Hoed
3
, H. Maas
4
,
R. van Ieperen
2
, G. J. Noordergraaf
2
1
Anesthesiology, Pain and Palliative Care, RadboudUMC, Nijmegen,
2
Anesthesiology, Pain Management & Resuscitation,
3
Department of
Surgery,
4
Department of Geriatric Medicine, Elisabeth Tweesteden
Hospital, Tilburg, Netherlands
Introduction:
Choosing the optimal anesthetic technique
for breast cancer surgery for a frail elderly patient is an
increasingly common challenge. General anesthesia with its
disadvantages is one of the items to consider in the decision
making process of whether to operate or not. We describe our
experience with epidural based anesthesia in breast cancer
surgery as an alternative to general anesthesia.
Objectives:
To evaluate the epidural based anesthesia for
breast cancer surgery in elderly patients.
Methods:
We performed a single center cohort study in
breast cancer surgery under thoracic epidural anesthesia.
Data were retrospectively derived from medical records and
PDMS Metavision™ in the Elisatbeth-Tweesteden hospital,