The impact of comprehensive geriatric assessment for optimal treatment of older patients with cancer: A randomized parallel-group clinical trial

• Published in: Journal of geriatric oncology Vol. 11; no. 3; pp. 488 - 495
• Main Authors: Nadaraja, Sambavy, Matzen, Lars-Erik, Jørgensen, Trine Lembrecht, Dysager, Lars, Knudsen, Anja Ør, Jeppesen, Stefan Starup, Möller, Sören, Herrstedt, Jørn
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-04-2020
• Subjects: Cancer; Comprehensive geriatric assessment; Gynecological cancer; Lung cancer; Older patient; Randomized controlled trial; Treatment decision; Urological cancer; Treatment decision; Comprehensive geriatric assessment; Urological cancer; Lung cancer; Older patient; Gynecological cancer; Randomized controlled trial; Cancer
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2019.06.019

The aim was to investigate if oncologic treatment decision based on G8 screening followed by comprehensive geriatric assessment (CGA) and a multidisciplinary team conference in patients with G8 ≤ 14 was better than treatment decision based on standard assessment. ClinicalTrials.gov Identifier: NCT02671994.
From January 2016 to June 2018, 96 patients with cancer, aged ≥70 years, were included. Patients were randomized to treatment decision based on the oncologist's clinical judgement (control) or based on screening with G8. If G8 > 14 treatment decision was made as in the control group and if G8 ≤ 14, patients were referred to CGA including intervention as needed and treatment decision after a multidisciplinary team conference (MDT).
The study was closed early. 47 patients were randomized to the control group and 49 to the intervention group; 28 had a G8 ≤ 14, 24 of whom attended CGA. In the intervention group 48% completed treatment as planned compared to 54% in the control group (p = .208). Thirty-eight percent experienced grade 3–4 toxicity in the control group compared with only 20% in the intervention group (p = .055). Median overall survival (OS) was 14.2 months in the control group and 19.1 months in the intervention group (p = .911). Median progression-free survival (PFS) was 9.0 months in the control group and 7.8 months for the intervention group (p = .838).
Treatment decision based on G8 screening followed by CGA had no impact on completion rate of planned oncologic treatment, OS or PFS, but resulted in a borderline significant lower incidence of grade 3–4 toxicity.