Advertisement

The usefulness of the Geriatric-8 screening tool and basic laboratory parameters in older patients with non-small cell lung cancer

Published:August 18, 2022DOI:https://doi.org/10.1016/j.jgo.2022.08.001
      Lung cancer, the third most common cancer, is the leading cause of cancer-related mortality and is frequently a disease of older patients [
      • National Cancer Institute
      SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer.
      ]. As a result of the under-representation of older patients with lung cancer in clinical trials, there is a lack of scientific knowledge on how to select this patient group for different anticancer strategies [
      • Battisti N.M.L.
      • Sehovic M.
      • Extermann M.
      Assessment of the external validity of the National Comprehensive Cancer Network and European Society for Medical Oncology guidelines for non-small-cell lung Cancer in a population of patients aged 80 years and older.
      ]. It is critical to recommend appropriate treatment after evaluating frailty, life expectancy, and treatment-related potential toxicities for older patients with lung cancer. Comprehensive geriatric assessment (CGA) is the gold standard for multidimensional evaluation that determines medical, psychological, functional status, nutrition, cognition, social activity, support, and polypharmacy; however, this process is time-consuming [
      • Hamaker M.E.
      • Jonker J.M.
      • de Rooij S.E.
      • Vos A.G.
      • Smorenburg C.H.
      • van Munster B.C.
      Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review.
      ]. Therefore, a two-step approach, beginning with a screening tool to select older patients with cancer who will benefit from CGA, has been proposed by the International Society of Geriatric Oncology (SIOG) [
      • Extermann M.
      • Aapro M.
      • Bernabei R.
      • Cohen H.J.
      • Droz J.P.
      • Lichtman S.
      • et al.
      Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG).
      ]. The Geriatric-8 (G8) score, created for oncologists as a quick and useful screening tool for assessing the frailty of older patients [
      • Bellera C.A.
      • Rainfray M.
      • Mathoulin-Pélissier S.
      • Mertens C.
      • Delva F.
      • Fonck M.
      • et al.
      Screening older cancer patients: first evaluation of the G-8 geriatric screening tool.
      ], was found to have a high sensitivity in predicting abnormalities in the CGA and was also associated with survival and treatment-related complications [
      • van Walree I.C.
      • Scheepers E.
      • van Huis-Tanja L.
      • Emmelot-Vonk M.H.
      • Bellera C.
      • Soubeyran P.
      • et al.
      A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer.
      ]. Although G8 scores have been shown to be associated with overall survival (OS) after curative radiotherapy in older patients with cancer, the predictive value of G8 varies between various tumor types [
      • Middelburg J.G.
      • Middelburg R.A.
      • van Zwienen M.
      • Mast M.E.
      • Bhawanie A.
      • Jobsen J.J.
      • et al.
      Impaired geriatric 8 score is associated with worse survival after radiotherapy in older patients with CANCER.
      ]. Regarding older patients with lung cancer, the diagnostic sensitivity of G8 is identified as reliable (89.8%) [
      • Soubeyran P.
      • Bellera C.
      • Goyard J.
      • Heitz D.
      • Curé H.
      • Rousselot H.
      • et al.
      Screening for vulnerability in older cancer patients: the ONCODAGE prospective multicenter cohort study.
      ], and impaired G8 has been found to be an independent prognostic factor for OS in patients treated with chemotherapy or chemoradiotherapy (CRT) [
      • Agemi Y.
      • Shimokawa T.
      • Sasaki J.
      • Miyazaki K.
      • Misumi Y.
      • Sato A.
      • et al.
      Prospective evaluation of the G8 screening tool for prognostication of survival in elderly patients with lung cancer: a single-institution study.
      ].

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Geriatric Oncology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • National Cancer Institute
        SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer.
        • Battisti N.M.L.
        • Sehovic M.
        • Extermann M.
        Assessment of the external validity of the National Comprehensive Cancer Network and European Society for Medical Oncology guidelines for non-small-cell lung Cancer in a population of patients aged 80 years and older.
        Clin Lung Cancer. 2017; 18: 460-471https://doi.org/10.1016/j.cllc.2017.03.005
        • Hamaker M.E.
        • Jonker J.M.
        • de Rooij S.E.
        • Vos A.G.
        • Smorenburg C.H.
        • van Munster B.C.
        Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review.
        Lancet Oncol. 2012; 13: e437-e444https://doi.org/10.1016/S1470-2045(12)70259-0
        • Extermann M.
        • Aapro M.
        • Bernabei R.
        • Cohen H.J.
        • Droz J.P.
        • Lichtman S.
        • et al.
        Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG).
        Crit Rev Oncol Hematol. 2005; 55: 241-252https://doi.org/10.1016/j.critrevonc.2005.06.003
        • Bellera C.A.
        • Rainfray M.
        • Mathoulin-Pélissier S.
        • Mertens C.
        • Delva F.
        • Fonck M.
        • et al.
        Screening older cancer patients: first evaluation of the G-8 geriatric screening tool.
        Ann Oncol. 2012; 23: 2166-2172https://doi.org/10.1093/annonc/mdr587
        • van Walree I.C.
        • Scheepers E.
        • van Huis-Tanja L.
        • Emmelot-Vonk M.H.
        • Bellera C.
        • Soubeyran P.
        • et al.
        A systematic review on the association of the G8 with geriatric assessment, prognosis and course of treatment in older patients with cancer.
        J Geriatr Oncol. 2019; 10: 847-858https://doi.org/10.1016/j.jgo.2019.04.016
        • Middelburg J.G.
        • Middelburg R.A.
        • van Zwienen M.
        • Mast M.E.
        • Bhawanie A.
        • Jobsen J.J.
        • et al.
        Impaired geriatric 8 score is associated with worse survival after radiotherapy in older patients with CANCER.
        Clin Oncol (R Coll Radiol). 2021; 33: e203-e210https://doi.org/10.1016/j.clon.2020.09.002
        • Soubeyran P.
        • Bellera C.
        • Goyard J.
        • Heitz D.
        • Curé H.
        • Rousselot H.
        • et al.
        Screening for vulnerability in older cancer patients: the ONCODAGE prospective multicenter cohort study.
        PLoS One. 2014; 9e115060https://doi.org/10.1371/journal.pone.0115060
        • Agemi Y.
        • Shimokawa T.
        • Sasaki J.
        • Miyazaki K.
        • Misumi Y.
        • Sato A.
        • et al.
        Prospective evaluation of the G8 screening tool for prognostication of survival in elderly patients with lung cancer: a single-institution study.
        PLoS One. 2019; 14e0210499https://doi.org/10.1371/journal.pone.0210499
        • Kaya V.
        • Yildirim M.
        • Demirpence O.
        • Yildiz M.
        • Yalcin A.Y.
        Prognostic significance of basic laboratory methods in non- small-cell-lung cancer.
        Asian Pac J Cancer Prev. 2013; 14: 5473-5476https://doi.org/10.7314/apjcp.2013.14.9.5473
        • Topkan E.
        • Bolukbasi Y.
        • Ozdemir Y.
        • Besen A.A.
        • Mertsoylu H.
        • Selek U.
        Prognostic value of pretreatment Glasgow prognostic score in stage IIIB geriatric non-small cell lung cancer patients undergoing radical chemoradiotherapy.
        J Geriatr Oncol. 2019; 10: 567-572https://doi.org/10.1016/j.jgo.2018.10.014
        • Schulkes K.J.G.
        • Souwer E.T.D.
        • van Elden L.J.R.
        • Codrington H.
        • van der Sar Brugge S.
        • Lammers J.J.
        • et al.
        Prognostic value of geriatric 8 and identification of seniors at risk for hospitalized patients screening tools for patients with lung Cancer.
        Clin Lung Cancer. 2017; 18 (e1): 660-666
        • Cuccia F.
        • Mortellaro G.
        • Mazzola R.
        • Donofrio A.
        • Valenti V.
        • Tripoli A.
        • et al.
        Prognostic value of two geriatric screening tools in a cohort of older patients with early stage non-small cell lung Cancer treated with hypofractionated stereotactic radiotherapy.
        J Geriatr Oncol. 2020; 11: 475-481https://doi.org/10.1016/j.jgo.2019.05.002
        • Harneshaug M.
        • Kirkhus L.
        • Benth J.Š.
        • Grønberg B.H.
        • Bergh S.
        • Whist J.E.
        • et al.
        Screening for frailty among older patients with cancer using blood biomarkers of inflammation.
        J Geriatr Oncol. 2019; 10: 272-278https://doi.org/10.1016/j.jgo.2018.07.003
        • Ando M.
        • Ando Y.
        • Hasegawa Y.
        • Shimokata K.
        • Minami H.
        • Wakai K.
        • et al.
        Prognostic value of performance status assessed by patients themselves, nurses, and oncologists in advanced non-small cell lung cancer.
        Br J Cancer. 2001; 85: 1634-1639https://doi.org/10.1054/bjoc.2001.2162
        • Hurria A.
        • Togawa K.
        • Mohile S.G.
        • Owusu C.
        • Klepin H.D.
        • Gross C.P.
        • et al.
        Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study.
        J Clin Oncol. 2011; 29: 3457-3465https://doi.org/10.1200/JCO.2011.34.7625
        • Hurria A.
        • Mohile S.
        • Gajra A.
        • Klepin H.
        • Muss H.
        • Chapman A.
        • et al.
        Validation of a prediction tool for chemotherapy toxicity in older adults with cancer.
        J Clin Oncol. 2016 Jul; 34: 2366-2371https://doi.org/10.1200/JCO.2015.65.4327