Predictors of tolerance to chemotherapy in older cancer patients: a prospective pilot study.
Few data are available to help predict which older cancer patient is at risk of developing chemotherapy-related toxicity. This study was a pilot for a project designing a predictive risk score. Chemotherapy patients aged 70 years and older were prospectively enrolled. Chemotherapies were adjusted for their published toxicity. 60 patients were enrolled, 59 were evaluable. Mean dose-intensity was 90.3%, range 33.3-129.0%. 47% of the patients experienced grade 4 haematological and/or grade 3-4 non-haematological toxicity. Published toxicity (MAX2), diastolic blood pressure, marrow invasion and lactate dehydrogenase (LDH) were all associated with toxicity (P<0.1); Body Mass Index, previous chemotherapy, red blood cells, platelets, polymedication with dose-intensity; and polymedication with FACT-G change. After adjustment for the published toxicity, the variables retained their significance, except for LDH and polymedication (for dose-intensity). Although the size of this pilot study imposes a cautious interpretation, patient-related and chemotherapy-related variables correlated independently with toxicity. Designing a composite predictive score to use in assessing the toxicity of multiple chemotherapy regimens therefore appears to be a valid undertaking.
H. Lee Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA. extermann@moffitt.usf.edu
M
M
Extermann
H
H
Chen
A B
AB
Cantor
M B
MB
Corcoran
J
J
Meyer
E
E
Grendys
D
D
Cavanaugh
S
S
Antonek
A
A
Camarata
W E
WE
Haley
L
L
Balducci
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies
D000970:Antineoplastic Agents