Predictors of three-month mortality and severe chemotherapy-related adverse events in patients aged 70 years and older with metastatic non-small-cell lung cancer: A secondary analysis of ESOGIA-GFPC-GECP 08-02 study.

Autor: Gendarme S; Univ Paris Est Creteil, INSERM, IMRB (CEpiA Team), F-94010 Creteil, France; Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, 40 avenue de Verdun, 94010 Créteil, France. Electronic address: sebastien.gendarme@u-pec.fr., Zebachi S; Univ Paris Est Creteil, INSERM, IMRB (CEpiA Team), F-94010 Creteil, France; Assistance Publique-Hôpitaux de Paris, Hôpital Henri-Mondor, Service de Santé Publique et Unité de Recherche Clinique, 1 Rue Gustave Eiffel, 94010 Créteil, France., Corre R; Centre Hospitalier Intercommunal de Cornouaille, Service de Pneumologie, 14 Av. Yves Thépot, 29000 Quimper, France., Greillier L; Aix-Marseille Université, AP-HM, INSERM, CNRS, CRCM, Hôpital Nord, Service d'Oncologie Multidisciplinaire et Innovations Thérapeutiques, Marseille, France., Justeau G; CHU d'Angers, Service de Pneumologie, 4 Rue Larrey, 49100 Angers, France., Bylicki O; HIA Sainte-Anne, Service de Pneumologie, 2, boulevard Saint-Anne, 83000 Toulon, France., Decroisette C; CH d'Annecy, Service de Pneumologie, 1, avenue de l'Hôpital, Metz-Tessy, 74374 Annecy, France., Auliac JB; Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, 40 avenue de Verdun, 94010 Créteil, France., Guisier F; Univ Rouen Normandie, LITIS Lab QuantIF team EA4108, CHU Rouen, France; Department of Pulmonology, Thoracic Oncology, and Respiratory Intensive Care & CIC-CRB INSERM 1404 F, 76000, Rouen, France., Geier M; CHU Morvan, Service de Pneumologie, 2, avenue Foch, 29200 Brest, France., Ricordel C; CHU Rennes, Service de Pneumologie, 2 Rue Henri le Guilloux, 35033 Rennes, France., Frelaut M; Gustave Roussy, Département d'Oncologie Médicale, 39 rue Camille-Desmoulins, 94805 Villejuif Cedex, France., Paillaud E; Univ Paris Est Creteil, INSERM, IMRB (CEpiA Team), F-94010 Creteil, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service de Gériatrie, 20, rue Leblanc, 75908 Paris Cedex 15, France., Chouaïd C; Univ Paris Est Creteil, INSERM, IMRB (CEpiA Team), F-94010 Creteil, France; Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie, 40 avenue de Verdun, 94010 Créteil, France., Canouï-Poitrine F; Univ Paris Est Creteil, INSERM, IMRB (CEpiA Team), F-94010 Creteil, France; Assistance Publique-Hôpitaux de Paris, Hôpital Henri-Mondor, Service de Santé Publique et Unité de Recherche Clinique, 1 Rue Gustave Eiffel, 94010 Créteil, France.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2024 Jul; Vol. 15 (6), pp. 101506. Date of Electronic Publication: 2023 May 19.
DOI: 10.1016/j.jgo.2023.101506
Abstrakt: Introduction: Predictors for mortality and toxicity in older patients with cancer are mainly studied in cohorts with various cancers at different stages. This study aims to identify predictive geriatric factors (PGFs) for early death and severe chemotherapy related adverse events (CRAEs) in patients aged ≥70 years with metastatic non-small-cell lung cancer (mNSCLC).
Material and Methods: This is a secondary analysis of the multicenter, randomized, phase 3 ESOGIA trial that compared, for patients ≥70 years with mNSCLC, a treatment algorithm based on performance status and age to another algorithm based on geriatric assessment. To identify PGFs of three-month mortality and grade 3, 4, or 5 CRAEs, multivariate Cox models and logistic models, adjusted for treatment group and center, and stratified by randomization arm, were constructed.
Results: Among 494 included patients, 145 (29.4%) had died at three months and 344 (69.6%) had severe chemotherapy toxicity. For three-month mortality, multivariate analyses retained mobility (Test Get up and Go), instrumental activity of daily living (IADL) dependence and weight loss as PGFs. The combined effect of IADL ≤2/4 and weight loss ≥3 kg was strongly associated with three-month mortality (adjusted hazard ratio: 5.71 [95% confidence interval [CI]: 2.64-12.32]). For chemotherapy toxicity, Charlson Comorbidity Index ≥2 was independently associated with grade3, 4, or 5 CRAEs (adjusted odds ratio [95% CI]: 1.94 [1.06-3.56]).
Discussion: Mobility, IADL dependence, and weight loss were predictive of three-month mortality in a population aged ≥70 years treated for mNSCLC, while comorbidities were independently associated with severe chemotherapy toxicity.
Competing Interests: Declaration of Competing Interest All authors have no conflicts of interest and disclosures.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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