Prospective comparison of the value of CARG, G8, and VES-13 toxicity tools in predicting chemotherapy-related toxicity in older Turkish patients with cancer

Çavdar, Eyyüp; İriağaç, Yakup; Karaboyun, Kubilay; Avcı, Okan; Şeber, Erdoğan Selçuk

doi:10.1016/j.jgo.2022.03.004

Cited by 15 publications

(4 citation statements)

References 27 publications

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“…This rate was 40% in the TH3RESA study, 25.7% in the KATHERINA study, and 37.5% in the KAMILIA study [7,29,30]. These differences in the incidence of adverse events between studies may be related to many factors, such as the median age of the patients included, performance status, treatment lines, and sites of metastasis [10,31]. The most common serious adverse events were fatigue, nausea, thrombocytopenia, and anemia, consistent with previous studies [10,32].…”

Section: Discussionsupporting

confidence: 76%

Efficacy and safety of trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer: a single center study

Çavdar¹,

Karaboyun²,

İriağaç³

et al. 2022

Iberoam J Med

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Introduction: Trastuzumab emtansine (T-DM1) is one of the effective treatment options in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients. In this study, we aimed to find the effect of T-DM1 on survival, its tolerability and prognostic factors of T-DM1 treatment. Material and methods: The study was designed as a single-center, retrospective study that included patients treated in the oncology department of a university hospital in Turkey. HER2-positive patients with metastatic breast cancer who had a progression response to trastuzumab and taxane treatment and received T-DM1 treatment for at least 2 months between 2016-2022 were included in the study. Adverse events were defined according to the Common Terminology Criteria for Adverse Events v5.0 (CTCAE). Kaplan-Meier methodology and Cox proportional hazard modelling were used for survival analyses. Results: The median progression-free survival (mPFS) for T-DM1 was 10.4 months and the median overall survival (mOS) was 22 months. In the created univariate cox regression model, liver metastasis, ECOG performance status, and pre-treatment serum CA 15-3 were found to be factors associated with PFS. Liver metastasis (HR=2.54, p=0.019), ECOG performance status (HR=4.66, p=0.002), and serum CA 15-3 (HR= 2.55, p=0.041) maintained their statistical significance for PFS in the established multivariate analysis. In the regression analysis for OS, only ECOG performance status (HR= 2.61, p=0.023) was found to be prognostic. While toxicity occurred in 46 (82.1%) of the patients, grade 3-4 toxicity developed in 10 (17.9%) patients. The most common side effects were anemia, thrombocytopenia, fatigue and nausea. Conclusions: T-DM1 is a safe and tolerable agent that prolongs survival. Liver metastasis, ECOG performance status, and pre-treatment serum CA 15-3 levels are independent prognostic factors for patients using T-DM1.

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Section: Discussionsupporting

confidence: 76%

Efficacy and safety of trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer: a single center study

Çavdar¹,

Karaboyun²,

İriağaç³

et al. 2022

Iberoam J Med

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“…The presently available literature about VES-13 in the majority refers to neoplastic diseases. According to some researchers, VES-13 is a feasible tool for predicting survival and qualifying for oncological treatment [10,64,65,68,69]. In our results, neoplastic diseases did not impact on VES-13 in multivariate design.…”

Section: Other Chronic Conditionssupporting

confidence: 43%

Cardiometabolic Disorders Are Important Correlates of Vulnerability in Hospitalized Older Adults

Kravchenko,

Korycka-Bloch,

Stephenson

et al. 2023

Nutrients

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With an increasingly aging population worldwide, the concept of multimorbidity has attracted growing interest over recent years, especially in terms of frailty, which leads to progressive multisystem decline and increased adverse clinical outcomes. The relative contribution of multiple disorders to overall frailty index in older populations has not been established so far. This study aimed to assess the association between the vulnerable elders survey-13 (VES-13) score, which is acknowledged to be one of the most widely used measures of frailty, and the most common accompanying diseases amongst hospitalized adults aged 60 years old and more. A total of 2860 participants with an average age of 83 years were included in this study. Multiple logistic regression with adjustment for age and nutritional status was used to assess the independent impact of every particular disease on vulnerability. Diabetes mellitus type 2, coronary artery disease, atrial fibrillation, heart failure, chronic kidney disease, osteoarthritis, fractures, eyes disorders, depression, dementia, pressure ulcers, and urinary incontinence were associated with higher scores of VES-13. Hospital admission of older subjects with those conditions should primarily draw attention to the risk of functional decline, especially while qualifying older patients for further treatment in surgery and oncology. At the same time, lipid disorders, gastrointestinal diseases, higher body mass index, and albumins level were related to a lower risk of being vulnerable, which may be attributed to a younger age and better nutritional status of those patients.

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“…Previous studies have also developed predictive models for chemotherapy toxicity in older adults with cancer that incorporate geriatric assessment variables. For example, the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) and the Cancer Aging Research Group (CARG) toxicity score have both been shown to represent reliable predictors of chemotherapy toxicity and overall survival in older cancer patients [ 8 , 12 , 26 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…GA-guided treatment plans have been shown to improve overall survival (OS), quality of life, physical function, and decrease the risk of hospitalization [ 6 , 7 ]. The available data also support the value of GA as an effective tool to predict the patient’s tolerance of cytotoxic interventions [ 8 ]. Most previous studies focused on the prediction of chemotherapy toxicity and showed that the factors most consistently associated with toxicity were functional status and comorbidity [ 9 – 14 ].…”

Section: Introductionmentioning

confidence: 88%

Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients

Paal,

Stranz,

Thurner

et al. 2023

Strahlenther Onkol

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Purpose The purpose of the present prospective study was to evaluate the significance of geriatric conditions measured by a comprehensive geriatric assessment (GA) for the prediction of the risk of high-grade acute radiation-induced toxicity. Methods A total of 314 prostate cancer patients (age ≥ 65 years) undergoing definitive radiotherapy at a tertiary academic center were included. Prior to treatment, patients underwent a GA. High-grade toxicity was defined as acute toxicity grade ≥ 2 according to standard RTOG/EORTC criteria. To analyze the predictive value of the GA, univariable and multivariable logistic regression models were applied. Results A total of 40 patients (12.7%) developed acute toxicity grade ≥ 2; high grade genitourinary was found in 37 patients (11.8%) and rectal toxicity in 8 patients (2.5%), respectively. Multivariable analysis revealed a significant association of comorbidities with overall toxicity grade ≥ 2 (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.260–5.502; p = 0.010) as well as with high-grade genitourinary and rectal toxicity (OR 2.169, 95%CI1.017–4.625; p = 0.045 and OR 7.220, 95%CI 1.227–42.473; p = 0.029, respectively). Furthermore, the Activities of Daily Living score (OR 0.054, 95%CI 0.004–0.651; p = 0.022), social status (OR 0.159, 95%CI 0.028–0.891; p = 0.036), and polypharmacy (OR 4.618, 95%CI 1.045–20.405; p = 0.044) were identified as independent predictors of rectal toxicity grade ≥ 2. Conclusion Geriatric conditions seem to be predictive of the development of high-grade radiation-induced toxicity in prostate cancer patients treated with definitive radiotherapy.

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Prospective comparison of the value of CARG, G8, and VES-13 toxicity tools in predicting chemotherapy-related toxicity in older Turkish patients with cancer

Cited by 15 publications

References 27 publications

Efficacy and safety of trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer: a single center study

Efficacy and safety of trastuzumab emtansine treatment in patients with metastatic HER-2 positive breast cancer: a single center study

Cardiometabolic Disorders Are Important Correlates of Vulnerability in Hospitalized Older Adults

Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients

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