Development of a geriatric vulnerability score in elderly patients with advanced ovarian cancer treated with first-line carboplatin: a GINECO prospective trial.
BACKGROUND
Two previous GINECO elderly specific studies in advanced ovarian cancer (AOC) patients highlighted the prognostic value of geriatric covariates for overall survival (OS).


METHODS
This open-label prospective trial was designed to identify the impact of geriatric covariates on OS in AOC patients ≥70 years treated with first-line carboplatin.


RESULTS
Geriatric covariates of the 111 patients included median age 79 years (≥80 years: 41%); performance status (PS) ≥2: 47%; ≥3 major comorbidities: 24%; ≥4 comedications: 68%; activities of daily living (ADL) score <6: 55%; instrumental activities of daily living (IADL) score <25: 69%; Hospital Anxiety and Depression Scale (HADS) >14: 37%. The median OS was 17.4 months. Overall, 74% of patients completed the six planned chemotherapy cycles. Grade 3-4 haematological toxic effects were frequent (50%) but manageable. Grade 3-4 non-haematological toxicities included fatigue (15%), anorexia (12%), infections (9%) and thrombosis (2%). A survival score = exp(0.327*GVS) was developed, where the geriatric vulnerability score (GVS) is the sum of the following (each assigned a value of one): albuminaemia <35 g/l; ADL score <6; IADL score <25; lymphopaenia <1 G/l; and HADS >14. With a cut-off ≥3, GVS discriminated two groups with significantly different OS, treatment completion, severe adverse events and unplanned hospital admissions rates.


CONCLUSIONS
The GVS is a valuable tool for identifying vulnerable patients when treating an elderly AOC population.
Geriatrics and Oncology Unit, Centre Hospitalier Lyon Sud, Université Lyon 1, Pierre-Benite.
C
C
Falandry
B
B
Weber
A-M
AM
Savoye
F
F
Tinquaut
O
O
Tredan
E
E
Sevin
L
L
Stefani
F
F
Savinelli
M
M
Atlassi
J
J
Salvat
E
E
Pujade-Lauraine
G
G
Freyer
D000368:Aged; D000369:Aged, 80 and over; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification / Q000473:pathology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D016190:Carboplatin
elderly; geriatrics; ovarian cancer; prognostic factors