Tolerance of Anti-Cancer Therapy in the Elderly
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Frailty
- Sponsor
- The Leeds Teaching Hospitals NHS Trust
- Enrollment
- 500
- Locations
- 1
- Primary Endpoint
- To validate the CARG scoring system
- Last Updated
- 4 years ago
Overview
Brief Summary
This is a multicentre observational study evaluating frailty and tolerance of chemotherapy in the elderly.
Detailed Description
This is a multicentre observational study evaluating frailty and tolerance of chemotherapy in the elderly. The number of people with cancer over the age of 65 years is increasing and more older patients are being treated with chemotherapy. Previous research has shown that patients living with frailty are more likely to experience significant toxicity from chemotherapy. A scoring system exists, the CARG (Cancer Aging Research Group) score), which using sociodemographics, tumour/treatment variables, laboratory test results (haemoglobin and creatinine clearance), geriatric assessment variables (function, co-morbidity, cognition, psychological state, social activity/support and nutritional status) predicts the likelihood of patients in this population developing a grade 3-5 toxicity. The CARG score ranges from 0 (lowest toxicity risk) to 19 (highest toxicity risk). This scoring system was developed and validated in the USA (United States of America). It was not however found to be predictive of toxicity in Australia. To date it has not been evaluated, nor is used in routine practice in oncology in the UK (United Kingdom). This study is looking at markers of frailty in patients \>65years. The investigators seek to predict those who are at a higher risk of side effects from chemotherapy. The investigators are looking to validate the CARG score in a UK NHS (National Health Service) population and show feasibility of using this in routine practice. The investigators are also evaluating if other scoring systems which are routinely used to assess frailty (but have never been assessed for predicting toxicity) are useful in predicting toxicity. Secondary objectives include describing frailty in this population, exploring patients' perceptions of risk associated with chemotherapy and demonstrating the added value of risk prediction tools compared to clinicians estimates of toxicity risk.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age \>65years
- •About to start first line chemotherapy for a solid tumour based malignancy
- •Chemotherapy given for any intent eg. adjuvant or palliative
- •Estimated survival of \>3months
- •Able to comprehend and complete questionnaire.
Exclusion Criteria
- •Medical or psychiatric condition impairing ability to consent
- •Participant is enrolled in another clinical trial
- •Prior chemotherapy for any indication
- •Receiving concurrent radiotherapy (RT) or immunotherapy (IT)
- •Unable to provide informed consent
Outcomes
Primary Outcomes
To validate the CARG scoring system
Time Frame: 6 months follow up
To validate the CARG scoring system (a score which is calculated by the doctor using patient information) in a UK real-world population and show feasibility of implementing CARG scoring in routine NHS practice. The investigators will collect the information required and calculate a CARG score for each participant. The investigators will record Grade 3-5 chemotherapy toxicities (as assessed using CTCAEv5) for each participant. The investigators will evaluate if the CARG score is predictive of Grade 3-5 toxicity (as assessed using CTCAEv5) in this UK real-world population. The investigators will record how long it takes to collect this information and calculate the score to see if it is feasible to implement this in a real world setting.
Secondary Outcomes
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy - demographics(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy - tumour type(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy - chemotherapy type(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy - laboratory test results (Hb)(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy - laboratory test results (CrCl)(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy using SIOG (International Society of Geriatric Oncology) Geriatric Screening Tool (G8)(6 months follow up)
- Describe frailty in elderly patients (>65years) in the UK NHS prior to starting chemotherapy using the Rockwood Clinical Frailty Score (CFS)(6 months follow up)
- Evaluate the predictive value of commonly used geriatric assessment tools in predicting chemotherapy tolerance(6 months follow up)
- The CARG score which reports the risk of grade 3-5 toxicity as assessed using CTCAEv5 as a percentage.(6 months follow up)
- Explore patients perception of risk associated with chemotherapy in this population(6 months follow up)