Prevalence of and factors associated with treatment modification at first cycle in older adults with advanced cancer receiving palliative treatment.
Chemotherapy dosing
Older adults with cancer
Treatment modification
Journal
Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
18
03
2021
revised:
09
06
2021
accepted:
18
06
2021
pubmed:
18
7
2021
medline:
15
12
2021
entrez:
17
7
2021
Statut:
ppublish
Résumé
Treatment toxicities are common in older adults with cancer and consequently, treatment modifications are sometimes considered. We evaluated the prevalence and factors associated with treatment modifications at the first cycle in older patients receiving palliative systemic treatment. Patients (n = 369) from the GAP 70+ Trial (NCT02054741; PI: Mohile) usual care arm were included. Enrolled patients were aged 70+ with advanced cancer and ≥ 1 Geriatric Assessment (GA) domain impairment. Treatment modification was defined as any change from National Comprehensive Cancer Network guidelines or published clinical trials. Baseline variables included: 1) sociodemographic factors; 2) clinical variables; 3) GA domains; and 4) physician beliefs about life expectancy. Bivariate analyses and multivariable cluster-weighted generalized estimating equation model were conducted to assess the association of baseline variables with cycle 1 treatment modifications. Mean age was 77.2 years (range: 70-94); 62% had lung or gastrointestinal cancers, and 35% had treatment modifications at cycle 1. Increasing age by one year (odds ratio (OR) 1.1, 95% confidence interval [CI] 1.0-1.2), receipt of ≥second line of chemotherapy (OR 1.8, CI 1.1-3.0), functional impairment (OR 1.6, CI 1.1-2.3) and income ≤$50,000 (OR 1.7, CI 1.1-2.4) were independently associated with a higher likelihood of cycle 1 treatment modification. Treatment modifications occurred in 35% of older adults with advanced cancer at cycle 1. Increasing age, receipt of ≥second line of chemotherapy, functional impairment, and lower income were independently associated with treatment modifications. These findings emphasize the need for evidence-based regimens in older adults with cancer and GA impairments.
Identifiants
pubmed: 34272204
pii: S1879-4068(21)00142-9
doi: 10.1016/j.jgo.2021.06.007
pmc: PMC8557119
mid: NIHMS1728270
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02054741']
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1208-1213Subventions
Organisme : NCI NIH HHS
ID : R00 CA237744
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA233167
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG059206
Pays : United States
Organisme : NCI NIH HHS
ID : K99 CA237744
Pays : United States
Organisme : NCI NIH HHS
ID : UG1 CA189961
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG059206
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG056589
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA177592
Pays : United States
Organisme : NIA NIH HHS
ID : K76 AG064394
Pays : United States
Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
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