Impact of frailty on outcome of elderly patients treated with hormone therapy for advanced/recurrent endometrial cancer (EC)

Konference: 2015 40th Congress ESMO a 18th ECCO - účast ČR

Kategorie: Zhoubné gynekologické nádory

Téma: Postery

Číslo abstraktu: P394/2731

Autoři: Florence Joly; MD Patricia Pautier; M.D. Ignace Vergote, Ph.D.; prof. MUDr. Bohuslav Melichar, Ph.D.; MD Elzbieta Kutarska; Georgina Hall; A. Lisayankaya; Prof. Dr. Nicholas Reed; Ana Oaknin; Valerijus Ostapenko; Dr. Zaneta Zvirbule; Eric Chetaille; M. Shoaib; Dr. John A. Green; Natacha Heutte

Background: A geriatric assessment of elderly EC patients can help in selection of therapy for advanced disease. The purpose of this study was to evaluate whether a Geriatric Score of Vulnerability (GSV) is associated with progression free survival (PFS) and quality of life (QoL) among elderly patients treated with hormone therapy with advanced/recurrent EC.

Material and Methods: Patients aged 65–85 years were recruited from a multicenter, randomized, open-label phase II trial that evaluated the oral steroid sulphatase inhibitor irosustat (BN83495) versus megestrol acetate (MA) (IPSEN X-55–58064–004; NCT00910091) in EC advanced disease. Oncogeriatric frailty parameters were evaluated before irosustat or MA treatment. GSV was defined as the sum of the different parameters: albuminaemia <35g/L; Activity of Daily Living (ADL) score <6; Instrumental Activities of Daily Living (IADL) score <5; lymphopaenia <1×109/L; and Mini Geriatric Depression Scale (GDS) >0. If three parameters were abnormal, the patient was considered as frail. QoL was assessed by the European Quality of Life-5 Dimensions (EQ-5D). Each of the five dimensions was divided into three levels of perceived problems.

Results: Characteristics of the 45 patients included in this study are as follows: age (median: 73.7 years, ≥70: 66%), ECOG (0: 53%, 1: 22%, 2: 18%, 3: 7%), stage (I: 36%, II: 9%, III: 38%, IV: 18%) positive progesterone receptor (76%), prior radiotherapy (58%), comorbidities (≥3: 67%), co-medications (1–3: 42%, 4–6: 17%, ≥7: 25%). No statistical difference of efficacy was observed between the two treatment arms. Thirteen percent of patients (5/38) had a GVS ≥3 (aged ≥70 years). Frailty was associated with poor PFS (median=2 months vs 6 months; p=0.0002). No relationship was observed between frailty and QoL. In all dimensions considered, QoL before treatment was not associated with PFS (p>0.18).

Conclusions: Age related frailty has a major impact on PFS of patients receiving hormone therapy for advanced EC.

No conflict of interest.

advanced/recurrent endometrial cancer
elderly patients
hormone therapy

Datum přednesení příspěvku: 28. 9. 2015