Impact of a comprehensive geriatric assessment to manage elderly patients with locally advanced non-small-cell lung cancers: a multicenter prospective study

Autores de IIS La Fe

• Francisco De Asís Aparisi Aparisi

  Autor

• Regina Gironés Sarrió

  Autor

Participantes ajenos a IIS La Fe

• Rondan M.A.
• Sánchez-Hernández A.
• Estellés D.L.
• Sánchez J.G.
• López J.S.
• Benajes R.T.

Grupos

• Unidad de Biomarcadores y Medicina de Precisión (UBYMP)

Abstract

Purpose: Concurrent chemoradiotherapy (cCRT) is the standard treatment for locally advanced and unresectable non-small-cell lung cancer. Population is aging, and Geriatric assessment (GA) has demonstrated its paper to select fit patients for active treatment and vulnerable, frail patients for interventions and/or palliative care in many histologies. Its role in locally advanced, unresectable non-small-cell lung cancer has been less explored. Methods: To assess the capability of GA to detect frail patients not suitable for active treatment, we developed this exploratory non-interventional prospective study. All patients = 70 years diagnosed with stage locally advanced and unresectable non-small-cell lung cancer were invited to undergo geriatric assessment. Secondary aims were description of population, exploring GA as prognostic factor, determination of toxicity profile and look for a frailty biomarker. Results: From June 2017 to June 2020, 51 patients were included, of whom 35% (n:18) were classified as frail. Frail patients had less overall survival and more grade 3–4 toxicity. Exploratory results for frailty phenotype are described in the text. Conclusions: With the results of our study, we confirm that GA can detect frail patients unsuitable for treatment, with a higher risk of toxicity and less overall survival. A trend toward blood-test results for phenotype frailty can be hypothesis generation. © The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO) 2024.

Keywords

• Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Chemoradiotherapy; Female; Frail Elderly; Frailty; Geriatric Assessment; Humans; Lung Neoplasms; Male; Prognosis; Prospective Studies; albumin; durvalumab; ferritin; interleukin 1; interleukin 6; iron; transferrin; tumor necrosis factor; adenocarcinoma; aged; Article; cancer palliative therapy; chemoradiotherapy; ex-smoker; female; geriatric assessment; histology; hospitalization; longitudinal study; male; multicenter study; never smoker; non small cell lung cancer; observational study; overall survival; skin fragility; very elderly; chemoradiotherapy; clinical trial; frail elderly; frailty; human; lung tumor; mortality; pathology; prognosis; prospective study; therapy