Aims: Evaluate the utility of Geriatric 8 Frailty (G8), Cancer and Aging Research Group’s (CARG) Toxicity Score, and combined G8-CARG score (points lost on G8 plus CARG), in predicting grade 3-5 chemotherapy/immunotherapy toxicity in older South Australian adults.
Methods: Those aged ≥ 70 years, with solid organ cancer, at any stage undergoing new line chemotherapy and/or immunotherapy recorded G8 and CARG score at baseline. Toxicities and emergent hospital encounters, during and up to 3 months post treatment were recorded retrospectively. Independent chi square test and simple linear regression assessed the scores’ predictive value.
Results: 109 patients from a single treatment centre, median age of 77 (range 70-91). Grade 3-5 toxicity was found in 64% (n=70), with 40% (n=43) requiring emergency department review. G8 score ≤ 14 and >14 comprised toxicity rates 63% and 68% respectively; relative risk 0.93 (95%CI: 0.68–1.26, p=0.64). Toxicity rates for low, intermediate and high CARG risk scores were 44%, 66% and 70% respectively, with non-significant relative risk between groups. Combined G8-CARG score quartile groups- low, intermediate, high and very high groups comprised toxicity rates 58%, 70%, 70% and 100% respectively. Relative risk between groups were non-significant, with similar linear regression findings (95%CI: -0.03-0.08, p=0.37).
Conclusion: Associations between G8, CARG and combined G8-CARG score to grade 3-5 toxicity did not reach statistical significance. The high rate of severe treatment related complications and emergent hospital presentations in this older cancer cohort underscores the need to propagate further studies into risk prediction tools in our local population.