The impact of comprehensive geriatric assessment for optimal treatment of older patients with cancer: A randomized parallel-group clinical trial

Sambavy Nadaraja*, Lars Erik Matzen, Trine Lembrecht Jørgensen, Lars Dysager, Anja Ør Knudsen, Stefan Starup Jeppesen, Sören Möller, Jørn Herrstedt, on behalf of the Academy of Geriatric Cancer Research (AgeCare)

*Corresponding author for this work

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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.

Original languageEnglish
JournalJournal of Geriatric Oncology
Volume11
Issue number3
Pages (from-to)488-495
ISSN1879-4068
DOIs
Publication statusPublished - Apr 2020

Keywords

  • Cancer
  • Comprehensive geriatric assessment
  • Gynecological cancer
  • Lung cancer
  • Older patient
  • Randomized controlled trial
  • Treatment decision
  • Urological cancer

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