Prognostic value of routine biomarkers in older patients with cancer: Pooled analysis of three prospective cohorts

Autor: Carine Bellera, Hubert Rousselot, Damien Heitz, Marianne Fonck, Sonia Zebachi, Pierre Soubeyran, Nadia Oubaya, Thomas Grellety, Florence Canoui-Poitrine, Etienne Brain, Nicoleta Reinald, Muriel Rainfray, Simone Mathoulin-Pélissier, Elena Paillaud, Mylene Allain, Michael Bringuier, Philippe Caillet, Jérôme Dauba, Sylvie Bastuji-Garin, Marie Laurent
Rok vydání: 2019
Předmět:
Zdroj: Journal of Clinical Oncology. 37:11551-11551
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2019.37.15_suppl.11551
Popis: 11551 Background: To assess prognostic value of routine biomarkers in older patients with cancer. Methods: A pooled analysis of three prospective multicentre cohorts, ELCAPA, PHRC Aquitaine and ONCODAGE was conducted. Patients aged 70 years or older, with cancer were included. Biomarkers collected were plasmatic C-reactive protein, albumin and a combined score: Glasgow Prognostic Score (GPS). The GPS comprised three categories (0: CRP≤10 mg/L, albumin≥35 g/L; 1: CRP≤10 mg/L and albumin < 35 g/L, or CRP > 10 mg/L and albumin≥35 g/L; 2: CRP > 10 mg/L and albumin < 35 g/L).The primary endpoint was overall survival at 12 months. Multivariable Cox models were used, adjusting for age, sex, localisation, metastatic status, performance status, frailty screening index, the G8. Discriminative properties were assessed using Harrell C index and NRI (Net Reclassification Improvement). Results: Overall 1800 patients were analyzed (ELCAPA: N = 543, PHRC Aquitaine: N = 253, ONCODAGE: N = 1004; mean age: 78.5±5.5 years; 61.7% of men; 37% metastatic; most frequent localisations: breast (34.9%) and colon-rectum (17.7%); 70.7% of patients screened at risk of frailty with G8). Overall survival was 71.1%. GPS was independently associated with death (among normal G8: GPS 1: Hazard Ratio (HR) = 4.48; 95% Confidence Interval (95% CI) = [2.03; 9.89], GPS 2: 11.64 [4.54; 29.81], among abnormal G8: GPS 1: 2.45 [1.79; 3.34], GPS 2: 3.97 [2.93; 5.37]. The addition of GPS to the clinical model (Harell C: 0.82 [0.80; 0.83]) improved discrimination (Harell C: 0.84 [0.82; 0.85], NRI: 11% [5; 19]). Conclusions: GPS could be used in older patients with cancer to help decision-making and prognosis assessment.
Databáze: OpenAIRE
Externí odkaz: