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A B S T R A C T S
S91
older patients with cancer warranting a complete geriatric
assessment.
Reference:
[1] Martinez-Tapia C, Canoui-Poitrine F, Bastuji-Garin S, et al.
Optimizing the G8 Screening Tool for Older Patients With
Cancer: Diagnostic Performance and Validation of a Six-
ItemVersion. Oncologist 2016; 21(2): 188-95.
Disclosure of interest:
None declared
Keywords:
Geriatric assessment, gold standard, screening
tools, vulnerability
P093
A RANDOMIZED CONTROLLED TRIAL OF GERIATRIC
ASSESSMENT GUIDED MULTIDISCIPLINARY
INTERVENTIONS: THE FIRST YEAR EXPERIENCE
D. Li
1,
*, C. Kelly
1
, M. Trent
1
, M. Fakih
1
, M. Koczywas
1
,
M. Cristea
1
, S. Pal
1
, V. Chung
1
, J. Mortimer
1
, Y. Yuan
1
,
P. Burhenn
1
, V. Katheria
1
, D. Rivera
1
, G. Varatkar
1
, K. Yu
1
,
S. Hite
1
, D. Mitani
1
, B. Ferrell
1
, A. Hurria
1
1
City of Hope, Duarte, USA
Introduction:
Geriatric assessment (GA) can predict
chemotherapy toxicity and identify potential interventions in
older adults with cancer.The National Comprehensive Cancer
Network and the International Society for Geriatric Oncology
currently recommends incorporating the use of GA and GA-
guided interventions in the care of older cancer patients.
Objectives:
The overall goal of this study is to determine the
effect of GA-guided multidisciplinary interventions in the care
of older adults with cancer beginning a new chemotherapy
regimen. In this abstract we describe the first year experience
of this randomized controlled trial.
Methods:
In this randomized controlled trial, 600 patients
age
65 with a diagnosis of solid tumor malignancy will be
randomized to GA intervention or standard of care in a 2:1
randomization. All patients complete a GA (Hurria et al.
Journal of Clinical Oncology 2016) prior to initiation of a new
chemotherapy regimen and a Cancer and Aging Research
Group (CARG) chemotherapy toxicity score is generated.
Patients randomized to the GA intervention arm have their
assessment results reviewed and summarized to form an
intervention plan. The results of the GA and intervention
recommendations are reviewed by a multidisciplinary team.
These recommendations are provided to the oncologist and
patient and then implemented by the study nurse. Patients
with a chemotherapy toxicity risk score
50% are co-managed
with the study nurse who has geriatric oncology expertise.
Patients randomized to the standard of care armalso complete
a GA, which is provided to their treating oncologist and nurse
for review. Grade 3-5 treatment-related toxicity (NCI CTCAE
v4.0), dose reductions or delays, emergency room visits and
unplanned hospitalizations are captured during treatment.
Results:
The study began in August 2015 and 21 physicians
throughout the Department of Medical Oncology enrolled
patients to the study. Out of 173 potentially eligible patients,
136 (79%) have enrolled. Participants had a median age of 72
(range 65-92) with gastrointestinal (28%), breast (22%), lung
(21%), genitourinary (17%), gynecological (7%), and other
types (5%) of malignancies. A majority of patients had stage
IV disease (84%). A CARG chemotherapy toxicity score was
generated for all patients: 30% low risk (N=40), 43% medium
risk (N=59), and 27% high risk (N=37). Based on GA results,
referrals to members of a multidisciplinary team were
recommended to 122/136 (90%) patients.A total of 395 referrals
to the following members of the multidisciplinary team were
made: 20% nutrition (N=78), 17% occupational therapy (N=67),
17% physical therapy (N=67), 16% social work (N=63), 15%
pharmacy (N=60), 5% chaplain (N=19), 1% neurology (N=6),
and 9% other (N=35).
Conclusion:
A high proportion of eligible patients enrolled
onto this prospective randomized controlled trial. Based on
GA results, referrals to members of the multidisciplinary team
were common. The large number of referrals indicates the
high level of medical burden among older adults with cancer.
The utility of a GA-guided multidisciplinary intervention to
decrease hospitalizations and toxicity will be determined
upon completion of this randomized controlled trial.
Disclosure of interest:
D. Li: None declared, C. Kelly: None
declared, M. Trent: None declared, M. Fakih: None declared,
M. Koczywas: None declared, M. Cristea: None declared, S.
Pal: None declared, V. Chung Speakers bureau: Celgene, J.
Mortimer: None declared, Y. Yuan: None declared, P. Burhenn:
None declared, V. Katheria: None declared, D. Rivera: None
declared, G. Varatkar: None declared, K. Yu: None declared,
S. Hite: None declared, D. Mitani: None declared, B. Ferrell:
None declared, A. Hurria Grant/Research Support from:
Celgene, Novartis, GSK, Consultant for: Boehringer Ingelheim
Pharmaceuticals, Carevive, Sanofi, GTx Inc.
Keywords:
Chemotherapy, geriatric assessment,
multidisciplinary interventions
P095
EVALUATION OF THE G8, VES-13 AND FRIED FRAILTY
CRITERIA AS SCREENING TOOLS FOR MULTIDIMENSIONAL
HEALTH PROBLEMS IN PATIENTS ENROLLED IN A PHASE
II TRIAL OF GERIATRIC ASSESSMENT AND MANAGEMENT
FOR OLDER ADULTS WITH CANCER
D. W. Yokom
1,
*, S. Alibhai
2,3
, M. Puts
4
1
Division of Medical Oncology,
2
Department of Medicine, University
of Toronto,
3
Department of Medicine, University Health Network,
4
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto,
Toronto, Canada
Introduction:
Screening tools are important aides for
oncologists to quickly identify older adults with cancer
who are at increased risk of toxicity, functional decline and
death and who could benefit from a comprehensive geriatric
assessment (CGA). These screening tools have not previously
been described for prediction of CGA-based interventions.
Objectives:
To assess the performance of the G8, VES-13,
and modified Fried Frailty Criteria (FFC) as screening tools for
an abnormal CGA or CGA-based medical interventions.