supportive care - Annals of Oncology

Annals of Oncology 25 (Supplement 4): iv517–iv541, 2014
doi:10.1093/annonc/mdu356.66
supportive care
1546P
ASSESSMENT OF OLDER PATIENTS WITH CANCER:
EDMONTON FRAIL SCALE (EFS) AS A PREDICTOR OF
ADVERSE OUTCOMES IN A COHORT OF OLDER PATIENTS
UNDERGOING SYSTEMIC THERAPY
M.M. O’Brien1, E.M. Pfeiffer2, D. Yen1, L. Keenan1, J. McHugh1, P. Doyle1,
M. Doherty1, A. O’Reilly1, B. Hennessy1, D. Williams2, A.M. Horgan1, O.
S. Breathnach1, W.M. Grogan1, P. Morris1
1
Dept of Medical Oncology, Beaumont Hospital, Dublin, IRELAND
2
Geriatric Medicine, Beaumont Hospital, Dublin, IRELAND
Table: 1546P
Patient Characteristics
Sex
Marital Status
Work Status
Cancer Diagnosis
Stage
Male
Female
Married
Widowed
Single
Divorced / separated
Retired
Part-time employed
Other
Colorectal
Breast
Other GI
Lung
Genitourinary
Others
I-III
IV
N/A (Brain)
N
%
10
14
10
8
4
2
22
1
1
6
6
3
3
2
4
12
11
1
42
58
42
33
17
8
92
4
4
25
25
13
13
8
17
50
46
4
abstracts
Conclusions: Preliminary results suggest elevated EFS score is associated with
toxicities during the first cycle of ST. Quantifying frailty could aid formation of a
predictive model for adverse events in the geriatric population.
Disclosure: P. Morris: Dr Patrick Morris; Honouraria GSK and Nordic. All other
authors have declared no conflicts of interest.
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Aim: Older cancer patients ( pts) are at risk of toxicity from systemic therapy (ST).
The EFS is a geriatric tool assessing frailty covering: Cognition, Health,
Independence, Performance, Social, Medications, Nutrition, Mood, and Continence.
It is unknown if the EFS can predict toxicity in pts who have already been selected for
ST. Prospectively we examined the EFS as a predictor of adverse outcomes in older
pts undergoing ST.
Methods: Candidates seen by a Medical Oncologist and deemed appropriate for ST
≥65years, starting new ST were included. EFS, demographics, diagnosis, ECOG
performance status (PS) and adverse events using the NCI CTCAE v4.03 were assessed.
The association between EFS and toxicity was examined during one treatment cycle
using Pearson’s correlation coefficient (r).
Results: From Feb-April 2014, 24 pts were included (table), median age 72 years (65–
92). EFS results were; No frailty 10 (42%), Apparently vulnerable 8 (33%), Mild
frailty 4 (17%), Moderate frailty 1 (4%) and Severe frailty 1 (4%). Many were of good
PS (54% had ECOG 1). All toxicities were recorded with most common non-lab
toxicities being fatigue 12 (50%) and pain 8 (33%), all ≤grade III. The most common
lab toxicities were Hb and Alk Phos. During ST there were 3 (13%) admissions, 6
(25%) had treatments held or dose adjustments and 1 death occurred. Age and
ECOG were significantly correlated (r=0.43, p = <0.04). Age was not associated with
toxicity events (r=0.19, p < 0.37). ECOG PS was not associated with total number of
toxicities (r=-0.05, p < 0.8). A moderate association between EFS and number of
toxicity events was seen (r=0.32), but did not reach statistical significance ( p < 0.14).
Updated results including toxicity on subsequent ST cycles from an expanded cohort
will be presented.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
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