G8 as a screening tool for comprehensive geriatric assessment in patients with breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24010-e24010
Author(s):  
Rocio Grajales ◽  
Alicia Gutierrez Mata ◽  
José Enrique Martínez Hernández ◽  
Alejandro Zavala-Calderon

e24010 Background: G8 is a geriatric screening tool designed to identify elderly cancer patients who benefit from a comprehensive geriatric assessment (CGA). Despite the increase in the incidence of cancer in the geriatric patients, there is absence of trials targeting this population. Decisions are often made based on their age and ECOG/Karnofsky scales, which does not reflect the actual role of an elderly patient. It is necessary to identify patients who require a CGA for an accurate evaluation and optimal oncological management. The routine implementation of the G8 geriatric screening tool in the oncology consultation consumes little time and is useful for timely referral of vulnerable patients to specialized care, in order to generate a positive impact on oncological therapy decision-making, improving their outcomes. Our main objective was to determine, using the geriatric screening tool G8, the percentage of patients aged >65 years with breast cancer, which require a CGA. Methods: The G8 questionnaire was applied to patients >65 yo with a diagnosis of breast cancer from December 2019 to May 2020. The baseline characteristics were prospectively collected and included clinical and demographic characteristics. The prognostic value of the functional status of the ECOG was evaluated and compared with that obtained from the G8. The difference between groups was assessed using Pearson's chi square with Yates correction. Additional scores were calculated using the Kaplan-Meier method and compared between groups using the log rank test. The hazard ratio with a 95% confidence interval was estimated using a Cox proportional hazards analysis, considering an abnormal G8 score as an exposure variable. Spearman correlation was made between age and the G8 score obtained. SPSS v22 software (IBM, USA) was used for all analyzes. Results: From December 2019 to May 2020, 357 patients were recruited. The mean age was 73.57 years (SD+7.02 y). The most frequent clinical stage was IIA (27.7%), followed by I (21.8%). 74.2% had an ECOG 1. Regarding treatment, 317 patients (88.8%) were on hormone therapy. The percentage of patients requiring a CGA was 44.3% (n = 158), of which only 55.1% (n = 87) were performed. We found no significant association between the requirement of CGA and clinical stage (p = 0.27) or treatment received (p = 0.345); but according to the ECOG, we obtained statistical significance p < 0.0001. Spearman correlation was performed between age and the G8 score, a correlation of 0.422 was obtained with p < 0.0001.The most affected domains of G8 were polypharmacy (51%) and ingestion (28.3%). Disease-free survival analysis was performed, without finding differences between vulnerable-frail and healthy patients. Conclusions: The G8 is a tool that allows to discern which patients require a CGA, in order to carry out interventions to improve comprehensive cancer treatment, so it should be implemented routinely in the oncology consultation.

2011 ◽  
Vol 2 (2) ◽  
pp. 130-136 ◽  
Author(s):  
S. Valéro ◽  
V. Migeot ◽  
G. Bouche ◽  
N. Raban ◽  
B. Roullet ◽  
...  

1991 ◽  
Vol 9 (7) ◽  
pp. 1113-1123 ◽  
Author(s):  
D F Hayes ◽  
R Mesa-Tejada ◽  
L D Papsidero ◽  
G A Croghan ◽  
A H Korzun ◽  
...  

Three monoclonal antibodies (MAbs) (DF3, F36/22, CU18) were used to monitor expression of distinct epitopes present within a family of mucin-like, breast carcinoma-associated molecules. Primary tumor specimens from more than 190 stage II breast cancer patients were evaluated for expression of the high molecular weight antigens. With a median follow-up of 6 years, patients whose tumors exhibited high immunoperoxidase staining scores (greater than 50% positive cells) with MAb DF3 had a superior disease-free survival ([DFS] 56% +/- 6% v 37% +/- 5% at 6 years; P = .0088) and overall survival ([OS] 72% +/- 5% v 59% +/- 5% at 6 years; P = .025). Staining scores with the other two antibodies did not correlate with improved prognosis. For MAbs DF3 and CU18, patients whose tumors exhibited predominantly apical cellular reactivity patterns had improved DFS, although differences reached conventional levels of statistical significance only with MAb CU18. In multivariate analyses, the prognostic value of MAb DF3 staining was independent of other identified prognostic factors. Furthermore, the concordance between primary and axillary lymph node metastases staining with each MAb was 73%, 80%, and 85% for MAbs DF3, F36/22, and CU18, respectively. These results suggest that staining with MAb DF3 identifies a group of node-positive women with a relatively favorable prognosis. Expression of the DF3 mucin-like glycoprotein is related to better differentiation, and staining with MAb DF3 provides an accurate and objective estimate of clinical outcome independent of histopathologic evaluation.


1988 ◽  
Vol 6 (5) ◽  
pp. 825-831 ◽  
Author(s):  
J N Ingle ◽  
D I Twito ◽  
D J Schaid ◽  
S A Cullinan ◽  
J E Krook ◽  
...  

A randomized clinical trial was performed to determine if combination hormonal therapy with tamoxifen (TAM) and fluoxymesterone (FLU) was more efficacious than TAM alone for the treatment of postmenopausal women with metastatic breast cancer. Patients failing TAM could subsequently receive FLU. The dose of both drugs was 10 mg orally twice daily. Objective responses were seen in 50 of 119 TAM patients (42%) and 63 of 119 TAM plus FLU patients (53%) (one-sided P = .05). Time to disease progression distributions were better for TAM plus FLU (median, 350 days v 199 days), but the log rank test only approached statistical significance (one-sided P = .07). Duration of response and survival distributions were similar between the two treatment arms. Toxicities, in terms of androgenic side effects, were greater on the TAM plus FLU regimen. Fifty-two patients are evaluable for response with FLU following TAM and 21 (40%) have achieved a response. We conclude that the advantages in terms of response rate and time to progression observed with TAM plus FLU probably represent a biological effect, but are not of sufficient magnitude to justify the routine clinical use of this combination given the lack of survival advantage and side effects encountered.


2020 ◽  
Vol 21 (24) ◽  
pp. 9556
Author(s):  
Viktor Hlaváč ◽  
Radka Václavíková ◽  
Veronika Brynychová ◽  
Renata Koževnikovová ◽  
Katerina Kopečková ◽  
...  

Breast cancer is the most common cancer in women in the world. The role of germline genetic variability in ATP-binding cassette (ABC) transporters in cancer chemoresistance and prognosis still needs to be elucidated. We used next-generation sequencing to assess associations of germline variants in coding and regulatory sequences of all human ABC genes with response of the patients to the neoadjuvant cytotoxic chemotherapy and disease-free survival (n = 105). A total of 43 prioritized variants associating with response or survival in the above testing phase were then analyzed by allelic discrimination in the large validation set (n = 802). Variants in ABCA4, ABCA9, ABCA12, ABCB5, ABCC5, ABCC8, ABCC11, and ABCD4 associated with response and variants in ABCA7, ABCA13, ABCC4, and ABCG8 with survival of the patients. No association passed a false discovery rate test, however, the rs17822931 (Gly180Arg) in ABCC11, associating with response, and the synonymous rs17548783 in ABCA13 (survival) have a strong support in the literature and are, thus, interesting for further research. Although replicated associations have not reached robust statistical significance, the role of ABC transporters in breast cancer should not be ruled out. Future research and careful validation of findings will be essential for assessment of genetic variation which was not in the focus of this study, e.g., non-coding sequences, copy numbers, and structural variations together with somatic mutations.


Sign in / Sign up

Export Citation Format

Share Document