Geriatric assessment and biomarkers in patients with metastatic breast cancer receiving first-line mono-chemotherapy: Results from the randomized phase III PELICAN trial.

Friedemann Honecker, Nadia Harbeck, Claudia Schnabel, Ulrich Wedding, Dirk Waldenmaier, Steffen Saupe, Elke Jäger, Marcus Schmidt, Rolf Kreienberg, Lothar Müller, Burkhard Otremba, Julia Dorn, Mathias Warm, Salah-Eddin Al-Batran, Maike de Wit

Journal: Journal of geriatric oncology 2019;9(2):163-169

PMID: 29055624

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Abstract

OBJECTIVES

To determine predictive/prognostic factors for patients with metastatic breast cancer (MBC) receiving first-line monochemotherapy using biomarker analysis and geriatric assessment (GA).

MATERIALS AND METHODS

Karnofsky Performance Status (KPS) and GA as clinical parameters, and prognostic inflammatory and nutritional index (PINI), and Glasgow prognostic score (GPS) as biomarkers were analyzed for association with clinical outcome within the randomized phase III PEg-LIposomal Doxorubicin vs. CApecitabin iN MBC (PELICAN) trial of first-line pegylated liposomal doxorubicin (PLD) or capecitabine.

RESULTS

Of 210 patients, 38% were >65years old. GA (n=152) classified 74% as fit, 10% as compromised, and 16% as frail. Biomarkers showed no age dependency. In multivariate analysis (n=70) KPS, GA, cumulative illness rating scale-geriatrics (CIRS-G), and GPS were significantly associated with time to progression, and KPS, CIRS-G, and instrumental activities of daily living (IADL) from GA, and PINI showed a significant correlation with overall survival.

CONCLUSION

GA evaluation was feasible. KPS significantly correlated with efficacy outcomes. Items of a GA and biomarkers of inflammation and nutrition may have prognostic significance in patients with MBC.

Address: Department of Oncology/Hematology/Pneumology, University Medical Center Eppendorf, Martinitrasse 52, 20246 Hamburg, Germany; Tumor and Breast Center ZeTuP St. Gallen, Rorschacher Strasse 150, 9006 St. Gallen, Switzerland. Electronic address: [email protected].; Breast Center, Department of Obstetrics and Gynecology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany. Electronic address: [email protected].; Metabolic Laboratory and Newborn Screening, University Medical Center Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. Electronic address: [email protected].; Internal Medicine Clinic II, Department of Palliative Care, Jena University Hospital, Bachstrasse 18, 07743 Jena, Germany. Electronic address: [email protected].; MSD Sharp & Dohme, Lindenplatz 1, 85540 Haar, Germany. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Technical University of Munich, Arcisstrasse 21, 80333 Munich, Germany. Electronic address: [email protected].; Oncology and Hematology, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Johannes Gutenberg University, Saarstrasse 21, 55122 Mainz, Germany. Electronic address: [email protected].; Universitätsfrauenklinik, Prittwitzstrasse 43, 89081 Ulm, Germany. Electronic address: [email protected].; Onkologische Schwerpunktpraxis, Annenstrasse 11, 26789 Leer, Germany. Electronic address: [email protected].; Onkologische Praxis Oldenburg, Grüne Strasse, 26121 Oldenburg, Germany. Electronic address: [email protected].; Department of Obstetrics and Gynecology, Technical University of Munich, Arcisstrasse 21, 80333 Munich, Germany. Electronic address: [email protected].; Brustzentrum, Krankenhaus Köln-Holweide, Neufelder Strasse 32, 51067 Cologne, Germany. Electronic address: [email protected].; Oncology and Hematology, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany. Electronic address: [email protected].; Vivantes Klinikum Neukoelln, Rudower Strasse 48, 12351 Berlin, Germany. Electronic address: [email protected].

DOI: 10.1016/j.jgo.2017.09.009

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MeSH Terms: Age Factors, Aged, Biomarkers, Breast Neoplasms, Capecitabine, Disease Progression, Doxorubicin, Female, Frailty, Geriatric Assessment, Humans, Karnofsky Performance Status, Middle Aged, Polyethylene Glycols, Treatment Outcome