The impact of comprehensive geriatric assessment for optimal treatment of older patients with cancer: A randomized parallel-group clinical trial

OBJECTIVES: The aim was to investigate if oncologic treatment decision based on G8 screening followed by comprehensive geriatric assessment (CGA) and a multidisciplinary team conference in patients with G8???14 was better than treatment decision based on standard assessment. ClinicalTrials.gov Identifier: NCT02671994.

MATERIALS AND METHODS: From January 2016 to June 2018, 96 patients with cancer, aged ?70?years, were included. Patients were randomized to treatment decision based on the oncologist's clinical judgement (control) or based on screening with G8. If G8?>?14 treatment decision was made as in the control group and if G8???14, patients were referred to CGA including intervention as needed and treatment decision after a multidisciplinary team conference (MDT).

RESULTS: The study was closed early. 47 patients were randomized to the control group and 49 to the intervention group; 28 had a G8???14, 24 of whom attended CGA. In the intervention group 48% completed treatment as planned compared to 54% in the control group (p?=?.208). Thirty-eight percent experienced grade 3-4 toxicity in the control group compared with only 20% in the intervention group (p?=?.055). Median overall survival (OS) was 14.2?months in the control group and 19.1?months in the intervention group (p?=?.911). Median progression-free survival (PFS) was 9.0?months in the control group and 7.8?months for the intervention group (p?=?.838).

CONCLUSION: Treatment decision based on G8 screening followed by CGA had no impact on completion rate of planned oncologic treatment, OS or PFS, but resulted in a borderline significant lower incidence of grade 3-4 toxicity.