SABCS 2018: Novel Tool for Assessing Risk of Chemotherapy Toxicity in Older Patients With Breast Cancer
Posted: Wednesday, December 12, 2018
A tool to score the risk of chemotherapy toxicity in older patients with breast cancer receiving adjuvant treatment has been developed and validated, according to research presented by Allison Magnuson, DO, of the University of Rochester Strong Memorial Hospital, at the 2018 San Antonio Breast Cancer Symposium (SABCS; Abstract GS6-04). Additionally, a higher score was associated with dose reduction or delay, discontinuation of chemotherapy, hospitalization, and a relative dose intensity score of less than 85%.
The Cancer and Aging Research Group (CARG) established a chemotherapy toxicity score for older patients with all stages of solid tumor. In this prospective multicenter study, the investigators attempted to build upon the CARG score by developing and validating CARG-BC, a breast cancer–specific adjuvant.
A total of 501 patients at least 65 years of age were included in the study; however, 28 participants were excluded after receiving nonstandard treatment regimens. Of those remaining, 283 patients were assigned to the development group and 190, to the validation cohort. The development group comprised patients with stage I (39%), stage II (41%), and stage III (20%) breast cancers, with 65% having hormone receptor–positive disease, 24% having triple-negative disease, and 27% having HER2-positive disease.
Overall, 46% of the development cohort experienced grades 3 through 5 toxicity, which significantly corresponded with patients’ CARG scores (AUC = 0.64). When the additional qualifiers for breast cancer tumor and treatment as well as geriatric assessment variables were considered, the AUC improved to 0.76. The external validation AUC did not differ statistically (P = .15) from the development AUC, whereas the 10-fold internal validation AUC was 0.78.
“This tool could be considered as a part of adjuvant treatment decision-making,” suggested Dr. Magnuson and colleagues.
