Journal of Geriatric Oncology - Volume 7/6 - Supplement 1

A B S T R A C T S

S95

P100

A PILOT STUDY OF AN ACCELERATOR EQUIPPED

SMARTPHONE TO MONITOR OLDER ADULTS WITH CANCER

RECEIVING CHEMOTHERAPY IN MEXICO

E. Soto-Perez-De-Celis

*, M. P. Rojo-Castillo

Y. Chavarri-Guerra

, A. P. Navarrete-Reyes

, J. R. Waisman

J. A. Avila-Funes

, Á. Aguayo

, A. Hurria

Department of Geriatrics,

Department of Hemato-Oncology,

Instituto Nacional de Ciencias Médicas y Nutrición Salvador

Zubirán, Mexico City, Mexico,

Department of Medical Oncology &

Therapeutics Research,

Cancer and Aging Research Program, City

of Hope, Duarte, USA

Introduction:

Older adults with cancer in developing

countries face challenges accessing healthcare due to a lack

of personnel and infrastructure. There are no standard triage

mechanisms to report toxicities, and adverse events can go

unnoticed for considerable amounts of time. We hypothesize

that functional decline (defined as a decrease in the number of

daily steps) may be a novel method for the timely detection of

toxicity in older adults receiving chemotherapy in a resource-

constrained country.

Objectives:

1) To determine if it is feasible and acceptable

to monitor the number of daily steps of older adults with

cancer receiving chemotherapy using a smartphone; 2) To

explore if a decline in the number of daily steps is associated

with toxicity.

Methods:

Patientsaged



65startingafirstlinechemotherapy

regimen for any solid tumor underwent a geriatric assessment

and were given an accelerometer-equipped smartphone with

a cloud-based pedometer application (Google Fit). Baseline

daily steps were recorded pre-chemotherapy and then

monitored daily for the first cycle. If a



15% decline from

baseline was identified, the patient was called by a physician

and the presence of toxicity was assessed. Interventions, such

as prescribing over-the-counter medications or advice to get

medical attention were instituted accordingly. With a sample

size of 40 patients, the intervention would be considered

feasible if



75% of subjects recorded steps for at least 75% of

planned days, and acceptable if



70% of subjects considered

the device easy to use utilizing a Visual Analog Scale. The

study received research ethics approval.

Results:

Forty patients (median age 73 [range 65-89]; 57%

[N=23] female) were accrued between September 2015 and

April 2016. Seventy percent (N=28) had stage III or IV disease

with 45% (N=18) GI, 23% (N=9) breast, and 32% (N=13) other

malignancies. The median distance from the patients’ home

to our hospital was 23 km (range 1.9-1232); 63% (N=25) lived

alone or with another older adult; and 60% (N=24) had less

than a high-school education. Fifty-seven percent (N=23) were

dependent in one or more IADLs; mean Timed Up and Go was

12 seconds (SD 3); 35% (N=14) reported falls in the previous

6 months; and 37% (N=15) and 32% (N=13) had hearing and

visual impairment respectively. Mean pre-treatment daily

steps were 3111 (range 208-7720, SD 1731), and median follow-

up was 21 days (range 2-28). Although only 23% (N=9) had

previously used a smartphone, most (93%) patients used the

device appropriately and recorded steps, and 85% found it easy

to use. All patients had at least one day with a



15% decline in

the number of steps (median 10 days; range 1-18). The median

number of calls per patient was 11 (range 1-25), which led

to the identification of 159 grade



2 toxicities in 31 patients

(73% [N=116] grade 2 and 27% [N=43] grade 3), most commonly

fatigue (26%) and diarrhea (15%). In an exploratory analysis,

we found that 46% of toxicities (n=57) led to interventions. Of

the 28% (N=11) of patients needing urgent medical attention

or hospitalization, most (N=10) were detected by a decrease in

the number of steps.

Conclusion:

Using smartphones to monitor the number of

daily steps of older adults with cancer receiving chemotherapy

in a resource-constrained setting is feasible and acceptable.

A decrease in the number of daily steps was common and

helped to identify chemotherapy toxicity. Further studies

assessing this novel monitoring strategy in older adults with

cancer are needed.

Disclosure of interest:

E. Soto-Perez-De-Celis: None declared,

M. P. Rojo-Castillo: None declared, Y. Chavarri-Guerra Grant/

Research Support from: Roche, Pfizer, A. P. Navarrete-Reyes:

None declared, J. Waisman: None declared, J. A. Avila-Funes:

None declared, Á. Aguayo: None declared, A. Hurria Grant/

Research Support from: Celgene, Novartis, GSK, Consultant

for: Seattle Genetics, OptumHealth Care Solutions, Inc.,

GTx, Inc., Boehringer Ingelheim Pharmaceuticals, Carevive

(formerly On Q Health), Sanofi

Keywords:

Developing countries, mobile applications,

monitoring, ambulatory, remote sensing technology, toxicity

P101

IMPLEMENTATION OF A GERIATRIC ONCOLOGY UNIT TO

HELP OLDER CANCER PATIENTS WITH DECISION-MAKING

E. Bustamante Maldonado

*, M. Domènech Santasusana

A. Baraldés Farré

Internal Medicine,

Oncology, Althaia Manresa-Barcelona,

Manresa, Spain

Introduction:

The increase in life expectancy has resulted

in an increase of certain diseases, and improvements

in treatments have also led to the prevalence of some

Fig. 1 (abstract P100) – Study design.