Researchers at the Yale Cancer Center show that using a validated risk calculator has helped make informed treatment decisions in elderly cancer patients. Yale oncologists have identified the Cancer and Aging Research Group (CARG) calculator as a quick and useful tool to assess the likelihood of chemotherapy toxicity in geriatric patients, leading to significant changes in treatment. The data will be presented on September 25, 2021 at the American Society of Clinical Oncology (ASCO) Annual Quality Care Symposium.
âOlder Americans are the fastest growing segment of society and cancer risk increases with age,â said Alexander Mbewe, MD, postdoctoral fellow at the Yale Cancer Center. âAs older patients have unique issues and concerns compared to the younger population, we are constantly looking for tools like the CARG Calculator to add value to the care of these patients. “
In the study, researchers evaluated patients aged 65 and older who were diagnosed with cancer and treated at Smilow Cancer Hospital Care Centers in Connecticut, a network of community oncology clinics, which are part of the Yale Cancer Center. Doctors used the CARG tool to document the toxicity scores of 10 geriatric patients starting a new chemotherapy regimen and completed a subsequent survey between March and June 2021. Survey results captured perceived clinical value, time spent and obstacles to implementation. Baseline data was collected in February 2021 and included geriatric patients receiving a new chemotherapy regimen for a solid tumor.
The results of the study showed 180 new consecutive chemotherapies in geriatric patients. The use of the CARG score in new chemotherapy regimens increased from 6.5% of new cases in the first month to 26.4% in the third month. According to the data, 82% of providers found the CARG score useful for discussing the risks of chemotherapy with patients. In 32% of cases, the CARG score led to a decision to reduce the dose, and in 15% of cases, the CARG score led to a different treatment regimen. 65% of oncologists said they spent 5 minutes calculating toxicity, and 88% spent 10 minutes. 89% of oncologists said the CARG score was worth the extra time.
âWe are now in the process of evaluating the clinical outcomes correlated with the CARG calculator,â said Jane Kanowitz, MD, assistant professor of clinical medicine (medical oncology) at the Yale Cancer Center. “We expect the results to further encourage the use of geriatric risk assessment as part of shared decision-making in our oncology clinics and hopefully all cancer centers in the future. ”
Other Yale authors involved in this study are: Paula Pike, Russell Lewis, MD, Jeremy S. Kortmansky, MD, and Anne C. Chiang, MD, PhD.