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

PURPOSE Comprehensive geriatric assessment (CGA) is recommended to assess the vulnerability of elderly patients, but its integration in cancer treatment decision making has never been prospectively evaluated. Here, in elderly patients with advanced non-small-cell lung cancer (NSCLC), we compared a standard strategy of chemotherapy allocation on the basis of performance status (PS) and age with an experimental strategy on the basis of CGA. PATIENTS AND METHODS In a multicenter, open-label, phase III trial, elderly patients ≥ 70 years old with a PS of 0 to 2 and stage IV NSCLC were randomly assigned between chemotherapy allocation on the basis of PS and age (standard arm: carboplatin-based doublet if PS ≤ 1 and age ≤ 75 years; docetaxel if PS = 2 or age > 75 years) and treatment allocation on the basis of CGA (CGA arm: carboplatin-based doublet for fit patients, docetaxel for vulnerable patients, and best supportive care for frail patients). The primary end point was treatment failure free survival (TFFS). Secondary end points were overall survival (OS), progression-free survival, tolerability, and quality of life. RESULTS Four hundred ninety-four patients were randomly assigned (standard arm, n = 251; CGA arm, n = 243). Median age was 77 years. In the standard and CGA arms, 35.1% and 45.7% of patients received a carboplatin-based doublet, 64.9% and 31.3% received docetaxel, and 0% and 23.0% received best supportive care, respectively. In the standard and CGA arms, median TFFS times were 3.2 and 3.1 months, respectively (hazard ratio, 0.91; 95% CI, 0.76 to 1.1), and median OS times were 6.4 and 6.1 months, respectively (hazard ratio, 0.92; 95% CI, 0.79 to 1.1). Patients in the CGA arm, compared with standard arm patients, experienced significantly less all grade toxicity (85.6% v 93.4%, respectively P = .015) and fewer treatment failures as a result of toxicity (4.8% v 11.8%, respectively; P = .007). CONCLUSION 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.

DOI: 10.1200/JCO.2015.63.5839

Statistics

05002017
Citations per Year

81 Citations

Semantic Scholar estimates that this publication has 81 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Corre2016UseOA, title={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.}, author={Romain Corre and Laurent Greillier and Herv{\'e} Le Ca{\"{e}r and Clarisse Audigier-Valette and Nathalie Baize and Henri B{\'e}rard and Lionel Falchero and Isabelle Monnet and Eric Dansin and Alain Vergnen{\'e}gre and Marie Marcq and Chantal Decroisette and Jean-Bernard Auliac and Suzanna Bota and R{\'e}gine Lamy and Bartomeu Massut{\'i} and C{\'e}cile Dujon and Maurice P{\'e}rol and Jean-Pierre Daur{\`e}s and Renaud Descourt and Herv{\'e} L{\'e}na and Carine Plassot and Christos Choua{\"{i}d}, journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology}, year={2016}, volume={34 13}, pages={1476-83} }