Predicting cumulative incidence of adverse events in older patients with cancer undergoing first-line palliative chemotherapy: Korean Cancer Study Group (KCSG) multicentre prospective study

• Published in: British journal of cancer Vol. 118; no. 9; pp. 1169 - 1175
• Main Authors: Kim, Jin Won, Lee, Yun-Gyoo, Hwang, In Gyu, Song, Hong Suk, Koh, Su Jin, Ko, Yoon Ho, Shin, Seong Hoon, Woo, In Sook, Hong, Soojung, Kim, Tae-Yong, Kim, Sun Young, Nam, Byung-Ho, Kim, Hyun Jung, Kim, Hyo Jung, Lee, Myung Ah, Kwon, Jung Hye, Hong, Yong Sang, Bae, Sung Hwa, Koo, Dong-Hoe, Kim, Kwang-Il, Kim, Jee Hyun
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2018; Nature Publishing Group
• Subjects: 692/308/409; 692/4028/67/1059/99; Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Chemotherapy; Drug Resistance; Epidemiology; Molecular Medicine; Older people; Oncology; Palliation; Risk groups; Side effects; Toxicity
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-018-0037-6

Background Older patients have increased risk of toxicity from chemotherapy. Current prediction tools do not provide information on cumulative risk. Methods Patients aged ≥ 70 years with solid cancer were prospectively enrolled. A prediction model was developed for adverse events (AEs) ≥ Grade 3 (G3), based on geriatric assessment (GA), laboratory, and clinical variables. Results 301 patients were enrolled (median age, 75 years). Median number of chemotherapy cycles was 4. During first-line chemotherapy, 53.8% of patients experienced AEs ≥ G3. Serum protein < 6.7 g/dL, initial full-dose chemotherapy, psychological stress or acute disease in the past 3 months, water consumption < 3 cups/day, unable to obey a simple command, and self-perception of poor health were significantly related with AEs ≥ G3. A predicting model with these six variables ranging 0–8 points was selected with the highest discriminatory ability (c-statistic= 0.646), which could classify patients into four risk groups. Predicted cumulative incidence of AEs ≥ G3 was discriminated according to risk groups. Conclusions This prediction tool could identify the risk of AEs ≥ G3 after chemotherapy and provide information on the cumulative incidence of AEs in each cycle. Clinical Trial Id WHO ICTRP number, KCT0001071