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About half of all breast cancer patients are diagnosed at ≥ age of 65, and the burden of breast cancer is increasing among the elderly.
, however, there are currently limited tools to predict the toxicity risk of chemotherapy in early-stage breast cancer patients.
Allison et al. conducted a prospective study of ≥65-year-old stage I-III. breast cancer patients receiving new assisted chemotherapy or complementary chemotherapy in 16 institutions to analyze the age and clinical characteristics of predicting the toxicity of chemotherapy at level 3-5.
logistic regression to identify independent predictors of toxicity and incorporate them into the weighted variable scoring model.
model performance is evaluated using the area under the ROC curve (AUC) and fit excellence statistics.
model has been validated internally and externally.
473 patients (283 in the development queue and 190 in the validation queue), 46% developed level 3-5 chemotherapy toxicity.
identified eight independent predictive factors (weighted scores for each factor): cyclic drug use (1 point), PHASE II or III (3 points), planned treatment for 3 months (4 points), liver abnormalities (3 points), low hemoglobin (3 points), falls (4 points), walking restriction (3 points), and lack of social support (3 points).
3-5 chemotherapy toxicity risk researchers calculated the risk score for each patient and defined three risk groups: the low risk group (0-5), the medium risk group (6-11 points), or the high risk group (≥12 points).
in the development queue, the rates of 3-5 levels of chemotherapy toxicity were 19%, 54% and 87%, respectively.
in the validation queue, the toxicity rates of the three groups were 27%, 45% and 76%, respectively.
CARG-BC rated 0.75 (95% CI, 0.70-0.81) with a 3-5 level chemotherapy toxicity development queue and the AUC of the validation queue was 0.69 (95% CI, 0.62-0.77).
risk groups were also associated with the rate of hospitalization and reduced dose intensity (p.lt;0.01).
in summary, the Cancer and Aging Research Group -Breast Cancer (CARG-BC) score has been developed and has been validated to predict the risk of level 3-5 chemotherapy toxicity during chemotherapy in older patients with early breast cancer.
