A United Kingdom prospective, multicentre, observational cohort study investigating tolerance of anti-cancer systemic therapy in the elderly: The TOASTIE study.

• DOI: 10.1200/jco.2024.42.16_suppl.1521
• Publication Date: 2024-06-04T18:44:16Z
• Authors: Helen Clare Dearden; Michael Rowe; Adam Peters; Maria Rohan; Alexandra Marsh; Abigail Louise Gee; Kieran Zucker; Gemma Quesne; Jonathan Heseltine; Rachel Prichard; Deborah Scott; Conor ONeill; Clair Brunner; Joni Howells; Veronica Conteh; Avinash Aujayeb; Xiangfei Yan; Lisa Jane Rodgers; Sally Martin; Mark Baxter
• Keywords: Systemic therapy

1521 Background: Older adults have a higher risk of developing chemotherapy (CTx) related toxicity. The Cancer Aging Research Group (CARG) score was developed and validated in the USA to predict severe CTx induced toxicity older adults; subsequent validation studies had varying results. TOASTIE study sought evaluate CARG prospectively United Kingdom (UK) population. Methods: This multicentre, prospective, observational recruited patients aged ≥65 years commencing first-line neo-adjuvant, adjuvant or palliative for any solid organ malignancy. Those receiving non-CTx agents were excluded. Baseline demographics established frailty measures recorded, including Eastern Cooperative Oncology performance status (ECOG PS), Rockwood Clinical Frailty Scale (CFS), Geriatric-8 (G8) Charlson Co-morbidity Index (CCI). calculated after initial consultation. Follow-up data CTCAEv5 hospital admissions collected retrospectively. Results: 19 centres 330 between Nov 2019 - Dec 2022. Median age 73 (range 65-92) 51.9% male. 54.9% primary tumour gastrointestinal origin, 48.7% received with intent 70.8% doublet therapy. At baseline, 85% an ECOG PS 0 1, median CFS 3 0-8), G8 12 6-16) CCI 6 2-12). available 314 (92.6%) patients; cycles 4 1-16) 124 (39%) dose reduced at cycle one. Treatment delays occurred 83 (26.4%) 123 (39.2%) stopped treatment early, 60 (48.8%) cases due treatment-related 69(22.3%) experienced CTCAE grade ≥3 84 (27%) requiring admission. 313 107 (34.2%) low risk, 167 (53.4%) medium 39 (12.5%) high risk. Increasing groups increased rates (low 19.6%, 22.2%, 28.2%) however this non-significant no evidence robust predictive (Table). superior CARG. Conclusions: In UK patient population, baseline prevalent. unable robustly discriminate high-grade showed superior, albeit limited, ability highlights need development further tools [Table: see text]