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Efficacy of Risk Calculator in Treating Elderly Patients With Cancer


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Researchers have shown that using a validated risk calculator helped to drive informed treatment decisions in older patients with cancer. Mbewe et al identified the Cancer and Aging Research Group (CARG) calculator as a quick and helpful tool in assessing chemotherapy toxicity probability in geriatric patients, leading to meaningful changes in treatment, according to data presented at the 2021 ASCO Quality Care Symposium (Abstract 209).

“Older Americans are the fastest-growing segment of society, and cancer risk increases with age,” said first study author Alexander Mbewe, MD, a postdoctoral fellow at Yale Cancer Center. “With older patients having unique issues and concerns compared with the younger population, we are constantly looking for tools like the CARG calculator to add value to the care of these patients.”

More About the CARG Calculator

KEY POINTS

  • 82% of providers found the CARG score helpful in discussing chemotherapy risks with patients, and 89% of oncologists reported that calculating the CARG score was worth the added time.
  • In 32% of cases, the CARG score led to a decision to dose attenuate, and in 15% of cases, the CARG score led to a different treatment regimen.

In the study, researchers assessed patients aged 65 years and older diagnosed with cancer and treated at Smilow Cancer Hospital Care Centers in Connecticut, a network of community-based oncology clinics that are part of Yale Cancer Center. Physicians used the CARG tool to document toxicity scores for 10 geriatric patients starting a new chemotherapy regimen and completed a post-survey between March and June 2021. The survey results captured perceived clinical value, time commitment, and barriers to implementation. Baseline data was collected in February 2021 and included geriatric patients receiving a new chemotherapy regimen for a solid tumor.

Study results showed 180 consecutive new chemotherapy starts in geriatric patients. The CARG score utilization in new chemotherapy starts increased from 6.5% of new cases during the first month to 26.4% in the third month. According to the data, 82% of providers found the CARG score helpful in discussing chemotherapy risks with patients. In 32% of cases, the CARG score led to a decision to dose attenuate, and in 15% of cases, the CARG score led to a different treatment regimen. Sixty-five percent of oncologists reported spending 5 minutes calculating toxicity, and 88% spent 10 minutes. Eighty-nine percent of oncologists reported the CARG score was worth the added time.

“We are now in the process of assessing clinical outcomes correlated with the CARG calculator,” said study coauthor Jane Kanowitz, MD, Assistant Professor of Clinical Medicine (Medical Oncology) at Yale Cancer Center. “We expect the results to further drive utilization of a geriatric risk assessment as part of shared decision-making in our oncology clinics and hopefully, in all cancer centers in the future.”

Disclosure: For full disclosures of the study authors, visit coi.asco.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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