Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial

Abstract

The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.

Safety and Efficacy of Extended Bevacizumab Therapy in Elderly (≥70 Years) Versus Younger Patients Treated for Newly Diagnosed Ovarian Cancer in the International ROSiA Study

“…Similarly, the GINECO group reported correlations between pretreatment functional status and toxicity, 22 and between decreased functionality and overall survival and toxicity. 23 Compared with younger patients, elderly patients are often undertreated. 24Y26 Furthermore, according to a recent population-based analysis, the increasing number of elderly patients receiving chemotherapy has not resulted in improved survival rates.…”

Delay in chemotherapy administration impacts survival in elderly patients with epithelial ovarian cancer

“…Additionally, these trials incorporate potentially valuable pre-treatment scoring systems in addition to dose modifications to improve tolerance of therapy in the elderly. Previous work by GINECO lead to the development of a geriatric vulnerability score, in which a score ≥ 3 was associated with high risk of severe toxicity, early cessation of treatment, and unplanned hospitalization [35]. Currently, this group is enrolling patients over age 70 with geriatric vulnerability score greater than 3 (EWOC-1); patients are randomized to (a) IV Paclitaxel 175 mg/m 2 with IV carboplatin AUC 5 every 3 weeks, (b) carboplatin monotherapy AUC 5 or 6 every 3 weeks, (c) paclitaxel 60 mg/m 2 with carboplatin AUC 2 (d1, d8, d15 every 4 weeks) [36].…”

Improving outcomes for older women with gynaecological malignancies

“…A deficit in 3 or more covariates resulted in a risk ratio of mortality of 2.94 (p=0.0006). This cut-off, also discriminated two groups with significantly different treatment completion, severe adverse events and unplanned hospital admissions rates [80]. The GINECO group are currently recruiting to a prospective phase 2 study evaluating standard 3 weekly dosing of Carboplatin and Paclitaxel, singleagent Carboplatin (AUC 5 or 6) every 3 weeks and dose dense weekly Carboplatin (AUC2) and weekly Paclitaxel (60mg/m2) in patients over the age of 70 with a GVS score of ≥ 3 (NCT02001272).…”

“…For example, in a retrospective analysis of the phase 3 AGO-OVAR 3 study (Carboplatin/Paclitaxel compared to Cisplatin/Paclitaxel in the first-line setting following cytoreductive surgery for advanced ovarian cancer), 103 patients over the age of 70 were compared to the under 70 years group (n=676). Over 80% of the patients in this analysis were ECOG PS 0 or 1 and the mean age of patients over 70 was 73.5 (range [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85]. The authors concluded that combination chemotherapy was tolerable in an older population but discontinuation rates were double in those over the age of 70 compared to the <70 group [40].…”

“…A further study from the same group led to the development of the Geriatric Vulnerability Score (GVS) [80]. 111 patients with a median age of 79 (range 71-93, 41% of whom were over the age of 80) and a diagnosis of advanced epithelial ovarian cancer received singleagent Carboplatin at AUC5.…”