84 / 154
S54
A B S T R A C T S
Conclusion:
1. Age specific reference ranges of PSA is
essential in interpreting PSA of elderly and our study showed
values that are similar to the expected. Interestingly, there is
a fall in the mean values of PSA in higher age brackets but this
is notstatistically significant.
2. The study also demonstrates that roughly 10% of the
elderly population in all age subsets has PSA values over the
normal.This is comparable to other studies and demonstrates
that routine PSA testing puts roughly 1 in 10 patients at risk
for biopsy.
3. Only 7 malignancies were picked up by the routine use
of PSA testing in the study population of 1038. i.e. 6.7 per 1000.
This brings us to the question of cost effectiveness of routine
PSA testing, particularly when it places roughly 10% at risk
for biopsy.
4. Malignancies were detected in patients with falling PSA
values also, hence questioning the value of serial estimations.
5. Malignancies were also detected in patients without
suspicious findings on P.R. examination.
6. On the other hand in all 3 patients who had both a rising
PSA and suspicious P.R. findings, who underwent biopsy were
positive for malignancy. This underscores the importance
of combining the two criteria for decision making regarding
biopsy.
Disclosure of interest:
None declared
Keywords:
Geriatric, prostate cancer, PSA
P032
A PHASE II STUDY OF THE COMBINATION OF BEVACIZUMAB
WITH CYTOTOXIC CHEMOTHERAPY, AS FIRST LINE
TREATMENT, IN OLDER PATIENTS WITH ADVANCED/
METASTATIC NSCLC (NON-SQUAMOUS) SELECTED BY A
GERIATRIC ASSESSMENT: GIDO1201
R. Gironés
1,
*, F. Aparisi
2
, M. Llorente
3
, B. Massuti
4
, M. Martín
5
,
A. Blasco
6
, S. Blasco
7
, O. Juan
8
, on behalf of GIDO and GIDO:
Grup d´investigació i divulgació en oncologia
1
Medical Oncology Unit, Hospital Lluis Alcanyis, Xàtiva,
2
Medical
Oncology Unit, Hospital Virgen de los Lirios, Alcoi,
3
Medical
Oncology Unit, Hospital de Elda, Elda,
4
Medical Oncology Unit,
Hospital General, Alicante,
5
Medical Oncology Unit, Hospital Doctor
Peset,
6
Medical Oncology Unit, Hospital General, Valencia,
7
Medical
Oncology Unit, Hospital de Sagunto, Sagunto,
8
Medical Oncology
Unit, Hospital Politecnic i Universitari la FE, Valencia, Spain
Introduction:
Bevacizumab when added to cytotoxic
chemotherapy in patients with NSCLC offers progression
free survival (PFS) and overall survival (OS) benefit. Most
patients with non–small-cell lung cancer (NSCLC) are elderly,
and age has important implications for their management
and treatment. All patients aged more than 70 years should
receive an assessment of physiologic age, including mortality
and toxicity prediction. Age itself does not contraindicate
treatment. However, the survival benefit for bevacizumab
added to chemotherapy seems limited to patients aged less
than 75 years.
Objectives:
The purpose of the present study was to
evaluate toxicity of an adapted regiment to elderly patients
selected by a geriatric assessment. We hypothesized that a
less dose-regimen administered to elderly patients selected
by an adapted geriatric assessment could decrease the rate of
neutropenia to 20%. Although a simple size of 51 patients was
needed to test this hypothesis, the study was halted after the
inclusion of 26 patients due to the slow recruitment.
Methods:
Chemotherapy naive NSCLC patients of non-
squamous histology,
70 years of age were eligible for this
study. Before enrolment all patients underwent geriatric
assessment. Patients with significant functional impairment
(ADL dependencies) or significant comorbidities (according to
Charlson Comorbidity Index CCI
4), aged
85 years old and/
or geriatric syndromes were excluded. The primary end-point
of the study was the overall toxicity rate. Patients were treated
with a modified regimen consisting on triweekly CBDCA AUC
4 + PTX 175 mg/m
2
+ B 7.5mg/kg
Results:
FromAugust 2013 until June 2015, 26 patients have
been enrolled. Median age was 76 and 20 (77%) were male.
20(77%) had PS 1.
All patients had ADL independence and median IADL was
6 (3-6). Median CCI was 1 (0-4). No patient had dementia or
was depressed.
Table (abstract P032) – Characteristics of patients included (n: 26)
Age median (SD)
77 (70-84)
Gender
Male (n; %)
20 (77%)
Female (n; %)
6 (23%)
Smoking habit
Active smoker
6 (23%)
Ex-smoker
13 (50%)
Never smoker
7 (27%)
Performancs Status ECOG
0
6 (23%)
1
20 (77%)
IADL (Lawton) (instrumental activities daily living)
5 (3-6)
(median, SD)
Comorbidity
Charlson (median, SD)
1 (0-4)
SCSS (median, SD)
3 (0-13)
Polypharmacy (median, SD)
6 (0-14)
Patients with any toxicity
25 (96%)
Toxicity grades 3-4
12 (46%)
Haematological toxicity G 3-4
4 (15%)
Non-hameatological toxicity G 3-4
10 (38%)
Haematologic toxicity was low (4 patients grades 3-4
toxicity: 15.4%) and also non-haematological toxicity (10
patients G3-4: 38.5%).Grade 3/4 neutropenia was observed
only in one patient (3.8). One fatal AE was observed due to
sepsis.
At the time of this preliminary analysis, median PFS was
8.22 months (6.0-10.3) and median OS was 11.6 (8.0-15.1). 3
patients are still on treatment.
Conclusion:
Bevacizumab in combination with a reduced
schedule of carboplatin and paclitaxel shows some efficacy
and less toxicity in elderly patients, however, in highly
selected elderly population. Our conclusions were limited by
the low accrual rate.
Disclosure of interest:
None declared
Keywords:
Bevacizumab, elderly non-small cell lung cancer,
Geriatric assessment, phase II trial