The impact of comprehensive geriatric assessment for optimal treatment of older patients with cancer: A randomized parallel-group clinical trial. Issue 3 (April 2020)

• Record Type: Journal Article
• Authors: Nadaraja, Sambavy; Matzen, Lars-Erik; Jørgensen, Trine Lembrecht; Dysager, Lars; Knudsen, Anja Ør; Jeppesen, Stefan Starup; Möller, Sören; Herrstedt, Jørn
• Is Part Of: Journal of geriatric oncology. Volume 11:Issue 3(2020)
• Page Start: 488
• Page End: 495
• Publication Date: 2020-04
• Subjects: Older patient -- Cancer -- Gynecological cancer -- Urological cancer -- Lung cancer -- Comprehensive geriatric assessment -- Treatment decision -- Randomized controlled trial; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2019.06.019
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Objectives: The aim was to investigate if oncologic treatment decision based on G8 screening followed by comprehensive geriatric assessment (CGA) and a multidisciplinary team conference in patients with G8 ≤ 14 was better than treatment decision based on standard assessment. ClinicalTrials.gov Identifier: NCT02671994. Materials and Methods: From January 2016 to June 2018, 96 patients with cancer, aged ≥70 years, were included. Patients were randomized to treatment decision based on the oncologist's clinical judgement (control) or based on screening with G8. If G8 > 14 treatment decision was made as in the control group and if G8 ≤ 14, patients were referred to CGA including intervention as needed and treatment decision after a multidisciplinary team conference (MDT). Results: The study was closed early. 47 patients were randomized to the control group and 49 to the intervention group; 28 had a G8 ≤ 14, 24 of whom attended CGA. In the intervention group 48% completed treatment as planned compared to 54% in the control group (p = .208). Thirty-eight percent experienced grade 3–4 toxicity in the control group compared with only 20% in the intervention group (p = .055). Median overall survival (OS) was 14.2 months in the control group and 19.1 months in the intervention group (p = .911). Median progression-free survival (PFS) was 9.0 months in the control group and 7.8 months for the intervention group (p = .838). Conclusion: Treatment decision based on G8 screening followed by CGA had no impact on completion rate of planned oncologic treatment, OS or PFS, but resulted in a borderline significant lower incidence of grade 3–4 toxicity.