Cited by 403Frailty in Older AdultsLung Cancer Diagnosis and TreatmentLung Cancer Research Studies

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Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study

Corre, Romain, Greillier, Laurent, Le Caër, Hervé, Audigier-Valette, Clarisse, Baize, Nathalie, Bérard, Henri, Falchero, Lionel, Monnet, Isabelle, Dansin, Eric, Vergnenègre, Alain, Marcq, Marie, Decroisette, Chantal, Auliac, Jean-Bernard, Bota, Suzanna, Lamy, Régine, Massuti, Bartomeu, Dujon, Cécile, Pérol, Maurice, Daurès, Jean-Pierre, Descourt, Renaud, Léna, Hervé, Plassot, Carine, Chouaïd, Christos·2016·Journal of Clinical Oncology

DOI 10.1200/jco.2015.63.5839

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Abstract

Purpose: Comprehensive geriatric assessment (CGA) is recommended to assess the vulnerability of elderly patients, but its integration in cancer treatment decision making has never been prospectively evaluated. Here, in elderly patients with advanced non–small-cell lung cancer (NSCLC), we compared a standard strategy of chemotherapy allocation on the basis of performance status (PS) and age with an experimental strategy on the basis of CGA. Patients and Methods: In a multicenter, open-label, phase III trial, elderly patients ≥ 70 years old with a PS of 0 to 2 and stage IV NSCLC were randomly assigned between chemotherapy allocation on the basis of PS and age (standard arm: carboplatin-based doublet if PS ≤ 1 and age ≤ 75 years; docetaxel if PS = 2 or age > 75 years) and treatment allocation on the basis of CGA (CGA arm: carboplatin-based doublet for fit patients, docetaxel for vulnerable patients, and best supportive care for frail patients). The primary end point was treatment failure free survival (TFFS). Secondary end points were overall survival (OS), progression-free survival, tolerability, and quality of life. Results: Four hundred ninety-four patients were randomly assigned (standard arm, n = 251; CGA arm, n = 243). Median age was 77 years. In the standard and CGA arms, 35.1% and 45.7% of patients received a carboplatin-based doublet, 64.9% and 31.3% received docetaxel, and 0% and 23.0% received best supportive care, respectively. In the standard and CGA arms, median TFFS times were 3.2 and 3.1 months, respectively (hazard ratio, 0.91; 95% CI, 0.76 to 1.1), and median OS times were 6.4 and 6.1 months, respectively (hazard ratio, 0.92; 95% CI, 0.79 to 1.1). Patients in the CGA arm, compared with standard arm patients, experienced significantly less all grade toxicity (85.6% v 93.4%, respectively P = .015) and fewer treatment failures as a result of toxicity (4.8% v 11.8%, respectively; P = .007). Conclusion: In elderly patients with advanced NSCLC, treatment allocation on the basis of CGA failed to improve the TFFS or OS but slightly reduced treatment toxicity.

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Authors: Corre, R., Greillier, L., Le Caër, H., Audigier-Valette, C., Baize, N., Bérard, H., Falchero, L., Monnet, I., Dansin, E., Vergnenègre, A., Marcq, M., Decroisette, C., Auliac, J.-B., Bota, S., Lamy, R., Massuti, B., Dujon, C., Pérol, M., Daurès, J.-P., Descourt, R., Léna, H., Plassot, C., & Chouaïd, C.
Affiliations: Centre Hospitalier Universitaire d'Angers (FR)
Romain Corre and Hervé Léna, Centre Hospitalier Universitaire de Rennes, Rennes; Laurent Greillier, Université de Médecine, Marseille; Hervé Le Caër, Centre Hospitalier de Draguignan, Draguignan; Clarisse Audigier-Valette, Centre Hospitalier Intercommunal de Toulon; Henri Bérard, Hôpital Inter Armées Sainte-Anne, Toulon; Nathalie Baize, Centre Hospitalier Universitaire d’Angers, Angers; Lionel Falchero, Centre Hospitalier de Villefranche sur Saône, Villefranche sur Saône; Isabelle Monnet and Christos...
ORCID: Corre, Romain
Greillier, Laurent
Audigier-Valette, Clarisse
Falchero, Lionel
Monnet, Isabelle
Marcq, Marie
Auliac, Jean-Bernard
Lamy, Régine
Descourt, Renaud
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2016-05-01
Volume: 34
Issue: 13
Pages: 1476-1483
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2015.63.5839
OpenAlex: W2281930375
Cited by: 403
References: 32
Citations by year: 2026: 18 · 2025: 11 · 2024: 37 · 2023: 35 · 2022: 47 · 2021: 40 · 2020: 50 · 2019: 40 · 2018: 56 · 2017: 43 · 2016: 23
FWCI: 31.02
Type: journal article
Language: en
Open access: closed
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
HAL (submittedVersion)
Funders: American Society of Clinical Oncology
Centre Hospitalier Universitaire de Rennes
National Cancer Institute
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords: comprehensive geriatric assessment, advanced non-small cell lung cancer, elderly patients, frailty, performance status, docetaxel, treatment toxicity, overall survival, best supportive care, geriatric oncology, treatment decision-making, quality of life, treatment tolerability
MeSH terms: Pemetrexed, Docetaxel, Gemcitabine, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Deoxycytidine, Female, Follow-Up Studies, Humans, Lung Neoplasms, Male, Neoplasm Staging, Prognosis, Quality of Life, Geriatric Assessment, Survival Rate, Carboplatin, Paclitaxel, Taxoids

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Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study

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