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

J Geriatr Oncol. 2018 Mar;9(2):163-169. doi: 10.1016/j.jgo.2017.09.009. Epub 2017 Oct 18.

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.

Keywords: Anthracycline; Biomarker; Capecitabine; Elderly; Geriatric assessment; Metastatic breast cancer; Pegylated liposomal doxorubicin; Prognostic factor.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Biomarkers / blood
  • Breast Neoplasms / drug therapy*
  • Capecitabine / adverse effects*
  • Disease Progression
  • Doxorubicin / adverse effects
  • Doxorubicin / analogs & derivatives*
  • Female
  • Frailty / diagnosis
  • Geriatric Assessment / methods*
  • Humans
  • Karnofsky Performance Status
  • Middle Aged
  • Polyethylene Glycols / adverse effects
  • Treatment Outcome

Substances

  • Biomarkers
  • liposomal doxorubicin
  • Polyethylene Glycols
  • Capecitabine
  • Doxorubicin