Predicting Risk of Severe Toxicity and Early Death in Older Adult Patients Treated with Chemotherapy

SIMPLE SUMMARY: Cancer therapy in the older adult remains a challenge; much is unknown about treatment tolerance and impact on survival in this age group. Factors predicting serious toxicity and early death (ED) were identified in a series of 234 older adult patients treated with chemotherapy. Two simple and reliable scores based on these factors were developed to predict the risk of grade 3–5 toxicity and ED, which can help in treatment planning and the implementation of corrective measures. ABSTRACT: Background: Determining the risk of grade 3–5 toxicity and early death (ED) is important to plan chemotherapy in older adult patients with cancer. Our objective was to identify factors predicting these complications at the time of treatment initiation. Methods: 234 patients aged ≥70 were subjected to a geriatric assessment and variables related to the tumor and the treatment were also collected. Logistic regression multivariable analysis was used to relate these factors with the appearance of grade 3–5 toxicity and ED. Predictive scores for both toxicity and ED were then developed. Results: Factors related to grade 3–5 toxicity were hemoglobin, MAX2 index, ADL, and the CONUT score. Factors related to ED were tumor stage and the GNRI score. Two predictive scores were developed using these variables. ROC curves for the prediction of toxicity and ED were 0.71 (95% CI: 0.64–0.78) and 0.73 (95% CI: 0.68–0.79), respectively. Conclusions: Two simple and reliable scores were developed to predict grade 3–5 toxicity and ED in older adult patients with cancer. This may be helpful in treatment planning.