학술논문
Assessing the ability of the Cancer and Aging Research Group tool to predict chemotherapy toxicity in older Japanese patients: A prospective observational study.
Document Type
Academic Journal
Author
Uchiyama M; Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Electronic address: muchiyama@fukuoka-u.ac.jp.; Miyazaki M; Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan.; Hayashi T; Department of Emergency and Disaster Medical Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, Japan.; Shimokawa M; Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamiogushi, Ube, Yamaguchi 755-8505, Japan.; Nakano T; Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Kakimoto H; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan.; Takaki S; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan.; Fukue H; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan.; Inoue T; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Inoue R; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Mashima K; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Kawata S; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Sumi Y; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Igarashi Y; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.; Kamimura H; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan.; Imakyure O; Department of Pharmaceutical and Health Care Management, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino-shi, Fukuoka 818-8502, Japan.; Matsuo K; Department of Oncology and Infectious Disease Pharmacy, Faculty of Pharmaceutical Sciences, Fukuoka University, 8-19-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan; Department of Pharmacy, Fukuoka University Hospital; 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101534770 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-4076 (Electronic) Linking ISSN: 18794068 NLM ISO Abbreviation: J Geriatr Oncol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: The Cancer and Aging Research Group (CARG) prediction tool was designed in the United States to predict grade ≥ 3 chemotherapy-related adverse events (CRAE) in older patients. However, its usefulness among Japanese people, who have different sensitivities to anticancer drugs and life expectancy, remains unknown. We aimed to prospectively evaluate the utility of the CARG tool for predicting severe CRAE in older Japanese patients with cancer.
Material and Methods: Patients with solid tumors aged 65 years and older who commenced anticancer drug regimens from April 2018 to October 2020 were divided into three groups (low, medium, and high-risk) based on their CARG risk scores. Toxicity was prospectively observed by a pharmacist. The primary objective was to evaluate the correlation between the incidence of grade ≥ 3 CRAE and the CARG risk score. The secondary objective was to evaluate hematological and non-hematological toxicities. CRAE incidence was compared among the three groups using a closed testing procedure: (1) Cochran-Armitage test for trend and (2) chi-square test for paired comparison.
Results: The patients (N = 165) had a median age of 71 years (range: 65-89 years). CRAE in patients divided into low-, medium-, and high-risk groups, based on CARG risk scores, were 39%, 55%, and 82%, respectively (low vs high; p < 0.001, medium vs high; p < 0.01). The incidence of severe hematologic toxicity was 37%, 35%, and 50% in the low-, medium-, and high-risk groups, respectively; the incidence of severe non-hematologic toxicity was 15%, 36%, and 65%, respectively (low vs medium; p < 0.01, low vs high; p < 0.001, and medium vs high; p < 0.01).
Discussion: To our knowledge, this is the first prospective observational study to validate the CARG prediction tool in older Japanese patients with cancer. The CARG risk score may be effective in predicting the development of non-hematologic toxicities. These results should be considered when administering chemotherapy to older Japanese patients with advanced solid tumors.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest directly relevant to the content of this article.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Material and Methods: Patients with solid tumors aged 65 years and older who commenced anticancer drug regimens from April 2018 to October 2020 were divided into three groups (low, medium, and high-risk) based on their CARG risk scores. Toxicity was prospectively observed by a pharmacist. The primary objective was to evaluate the correlation between the incidence of grade ≥ 3 CRAE and the CARG risk score. The secondary objective was to evaluate hematological and non-hematological toxicities. CRAE incidence was compared among the three groups using a closed testing procedure: (1) Cochran-Armitage test for trend and (2) chi-square test for paired comparison.
Results: The patients (N = 165) had a median age of 71 years (range: 65-89 years). CRAE in patients divided into low-, medium-, and high-risk groups, based on CARG risk scores, were 39%, 55%, and 82%, respectively (low vs high; p < 0.001, medium vs high; p < 0.01). The incidence of severe hematologic toxicity was 37%, 35%, and 50% in the low-, medium-, and high-risk groups, respectively; the incidence of severe non-hematologic toxicity was 15%, 36%, and 65%, respectively (low vs medium; p < 0.01, low vs high; p < 0.001, and medium vs high; p < 0.01).
Discussion: To our knowledge, this is the first prospective observational study to validate the CARG prediction tool in older Japanese patients with cancer. The CARG risk score may be effective in predicting the development of non-hematologic toxicities. These results should be considered when administering chemotherapy to older Japanese patients with advanced solid tumors.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest directly relevant to the content of this article.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)