Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study

Corre, Romain; Greillier, L.; Caer, H. Le; Audigier-Valette, Clarisse; Baize, Nathalie; Bérard, H.; Falchero, L.; Monnet, I.; Dansin, Éric; Vergnenègre, A.; Marcq, M.; Decroisette, C.; Auliac, J.B.; Bota, Suzanna; Lamy, R.; Massutí, Bartomeu; Dujon, C.; Pérol, Maurice; Daurès, Jean‐Pierre; Descourt, R.; Léna, H.; Plassot, Carine; Chouaïd, C.

doi:10.1200/jco.2015.63.5839

Cited by 341 publications

(189 citation statements)

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“…The elderly selection on geriatric index assessment (ESOGIA) study recently published by Corre et al in the Journal of Clinical Oncology compared treatment allocation based on age and performance status (PS) versus treatment allocation based on CGA (12). The main objective was to identify a survival difference between both arms.…”

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confidence: 99%

“…The lack of survival difference is also maybe due to the population of patients treated with BSC only: 23% in the CGA arm versus 0% in the PS and age group (12). The supplementary table A4 shows the number of patients in the PS and age group who would have received BSC only if treatment assignment had been performed with CGA: 27.3% in the group of patients treated with double therapy and 46% for patients treated with single therapy.…”

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confidence: 99%

“…As CGA-based treatment allocation is based on frailty, OS in the CGA arm for patients treated with BSC only or with single agent chemotherapy was thus shorter than in the PF and age arm (12). However, there is no data assessing whether BSC only is the appropriate option for these patients with poor natural prognosis.…”

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confidence: 99%

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Elderly selection on geriatric index assessment

Tomasini

Mascaux²

2016

Ann. Transl. Med.

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Elderly selection on geriatric index assessment

Tomasini

Mascaux²

2016

Ann. Transl. Med.

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“…In a retrospective analysis of CGA data for 249 consecutive cancer patients aged 70 years or more, an abnormal score on a geriatric depression scale was an independent predictor of poorer OS, but we found not such relationship (5). More recently (17) in a large multicenter, phase III trial, in elderly patients with advanced NSCLC, management allocation on the basis of CGA failed to improve OS but significantly reduced treatment toxicities. There is currently no agreed alternative to the CGA for patient selection.…”

Section: Discussionmentioning

confidence: 99%

“…In elderly patients with advanced-stage NSCLC, several phase II trials and a large phase III trial failed to show a clear benefit of using the CGA for allocation treatment (5,(15)(16)(17)(18)(19). In addition, the CGA has been criticised for being time-consuming, cumbersome and not standardised, and its real influence on treatment decisions in clinical practice has been questioned (12).…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of a comprehensive geriatric assessment on the management of elderly patients with advanced non-small cell lung cancer (NSCLC): a pooled analysis of two prospective phase II trials by the GFPC Group

Caer

Borget

Corre³

et al. 2017

J. Thorac. Dis.

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Background:The prognostic role of a comprehensive geriatric assessment (CGA) on the management of elderly patients with advanced-stage non-small cell lung cancer (NSCLC) remains to be established. The objective of this analysis was to determine the prognostic role of each CGA domain on overall survival (OS) among elderly patients with advanced-stage NSCLC.Methods: We pooled individual data from two prospective, randomized phases II trials in patients over 65 years old with advanced-stage NSCLC, who were considered fit (0405 trial) or no-fit (0505 trial) based on a CGA. Both trials compared first-line chemotherapy followed by second-line erlotinib with the reverse strategy in terms of progression-free survival (PFS) and OS. Factors prognostic of OS were sought by using the KaplanMeier method and the log rank test for univariate analysis, and a Cox model for multivariate analysis. were close to significance.Conclusions: PS and comorbidities appear to be the main predictors of OS in elderly advanced NSCLC patients selected on the basis of CGA.

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Patient Experience Captured by Quality-of-Life Measurement in Oncology Clinical Trials

et al. 2020

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IMPORTANCE Quality of life (QoL) is an important consideration in cancer medicine, especially because drugs are becoming more costly and may only result in modest gains in overall survival.However, there has been no descriptive analysis for the points at which QoL is measured in cancer trials.OBJECTIVE To estimate the prevalence of studies that measure QoL at different points and see how many studies measure QoL for the entirety of a patient's life. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis includes all articles ononcology clinical trials in the 3 highest-impact oncology journals, published between July 2015 and June 2018, that reported QoL outcomes. MAIN OUTCOMES AND MEASURESData were abstracted on when QoL was assessed and the characteristics of these studies. RESULTSFor all 149 studies that met inclusion criteria, QoL assessment was high during treatment (104 articles [69.8%]), during follow-up (81 articles [54.4%]), and after the end of the intervention (68 articles [45.6%]). In 5 of the 149 studies (3.4%), QoL was assessed until death, including in only 1 of the 74 studies on metastatic or incurable cancers. Among these 5 studies, only 1 (20%) used a drug intervention, 1 (20%) used a behavioral intervention, and 2 (40%) used a radiation intervention; only 1 of 5 was in the metastatic setting. The number of studies that reported a positive QoL outcome (ie, QoL outcome was more favorable in the intervention group than in the control group) was between 42 of 81 articles (51.9%) and 16 of 28 articles (57.1%) for most QoL assessment points but only 1 of 5 articles (20%) for studies measuring QoL until death. CONCLUSIONS AND RELEVANCEThis study found that most clinical trials assessed QoL during the treatment or intervention and often during a given amount of follow-up but infrequently assessed QoL on disease progression and rarely followed QoL until the end of the patient's life. Most studies reporting QoL until the end of life reported worse QoL outcomes for the intervention group than the control group. Future research and policy recommendations should consider not just short-term QoL outcomes but QoL outcomes throughout the patient's cancer care. Question How often do oncology studies assess quality of life (QoL) throughout a patient's disease course? Findings This cross-sectional analysis of 149 oncology studies published in highimpact medical and oncology journals found that most studies (69.8%) assessed QoL during the intervention, whereas only 3.4% of studies assessed QoL until the time of death. Meaning These findings suggest that many oncology studies only assess QoL during the intervention; future research should consider the long-term outcomes throughout the patient's life.Oncology, and JAMA Oncology. For each of the journals, we searched for the term quality of life on the journal's website, and we limited the search to research articles only. Selected articles needed to (1) be an RCT, (2) have performed the analysis in the originally randomized groups, (3) have evaluated QoL in ...

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Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study

Abstract: In elderly patients with advanced NSCLC, treatment allocation on the basis of CGA failed to improve the TFFS or OS but slightly reduced treatment toxicity.

Cited by 341 publications

References 32 publications

Elderly selection on geriatric index assessment

Elderly selection on geriatric index assessment

Prognostic role of a comprehensive geriatric assessment on the management of elderly patients with advanced non-small cell lung cancer (NSCLC): a pooled analysis of two prospective phase II trials by the GFPC Group

Patient Experience Captured by Quality-of-Life Measurement in Oncology Clinical Trials

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