The study’s lead investigator, Romain Corre, MD, Centre Hospitalier Universitaire de Rennes in France, wrote Cancer Therapy Advisor in an email the decision to focus on CGA in lung cancer patients arose, in part, from the researchers’ specialty in thoracic oncology, but also from lung cancer’s grim prognosis globally as the leading cause of cancer-related deaths in Western countries. Roughly 50% of patients with non-small cell lung cancers are 70 years or older at time of diagnosis.

Corre said CGA is not commonly performed in older patients with cancer in France, although it’s increasingly recommended.


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In the United States, these assessments also have not yet been integrated into decision-making in cancer treatment. But, in clinical trials, all investigators incorporate some comprehensive measures, such as nutritional status and weight loss, Shakun Malik, MD, head of thoracic oncology therapeutics at the National Cancer Institute in Bethesda, MD, told Cancer Therapy Advisor.

Overall, patient’s functional performance, measured in 4 different categories, is the most important factor in enrollment, more so than age, she said.

Although Malik described the CGA study as important, she said even the finding that these assessments lessened toxicity loses statistical significance once the investigators eliminated patients on best supportive care alone. As to which tools work best to predict outcomes in older patients with cancer, she said, more study and further discussion are needed.

Roy Herbst, MD, PhD, chief of medical oncology at Yale Cancer Center in New Haven, CT, agreed.

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“These studies are not done very often and there need to be more,” he told Cancer Therapy Advisor, adding that Yale is in the midst of a similar study in older patients with cancer right now.

But he applauded the European effort as important and “worthy of comment,” with the caveat that any tool is “only as good as the therapies you’re using” to treat patients with lung cancer or any other cancer.

Reference

  1. Corre R, Greillier L, Le Caer H, et al. Use of a comprehensive geriatric assessment for the management of elderly patients with advanced non-small-cell lung cancer: the phase III randomized ESOGIA-GFAC-GECP 08-02 study [published online ahead of print February 16, 2016]. J Clin Oncol. doi: 10.1200/JCO-2015.63.5839.