PURPOSE Performance status (PS) is a subjective assessment of patients' overall health. Quantification of physical activity using a wearable tracker (Fitbit Charge [FC]) may provide an objective measure of patient's overall PS and treatment tolerance. MATERIALS AND METHODS Patients with colorectal cancer were prospectively enrolled into two cohorts (medical and surgical) and asked to wear FC for 4 days at baseline (start of new chemotherapy [± 4 weeks] or prior to curative resection) and follow-up (4 weeks [± 2 weeks] after initial assessment in medical and postoperative discharge in surgical cohort). Primary end point was feasibility, defined as 75% of patients wearing FC for at least 12 hours/d, 3 of 4 assigned days. Mean steps per day (SPD) were correlated with toxicities of interest (postoperative complication or ≥ grade 3 toxicity). A cutoff of 5,000 SPD was selected to compare outcomes. RESULTS Eighty patients were accrued over 3 years with 55% males and a median age of 59.5 years. Feasibility end point was met with 68 patients (85%) wearing FC more than predefined duration and majority (91%) finding its use acceptable. The mean SPD count for patients with PS 0 was 6,313, and for those with PS 1, it was 2,925 (122 and 54 active minutes, respectively) ( P = .0003). Occurrence of toxicity of interest was lower among patients with SPD > 5,000 (7 of 33, 21%) compared with those with SPD < 5,000 (14 of 43, 32%), although not significant ( P = .31). CONCLUSION Assessment of physical activity with FC is feasible in patients with colorectal cancer and well-accepted. SPD may serve as an adjunct to PS assessment and a possible tool to help predict toxicities, regardless of type of therapy. Future studies incorporating FC can standardize patient assessment and help identify vulnerable population.

No abstract

Germline DNA evaluation is an increasingly common practice in in oncologic hereditary risk assessment and treatment selection in no small part because multigene assays allow more comprehensive DNA analysis at lower cost and improve accessibility to germline testing for patients and at-risk individuals thanks to more expansive testing criteria. Also critical has been the introduction of tumor-normal genomic testing, where germline analysis serves primarily to filter somatic-only variants for targeted therapy and secondarily as a source of hereditary risk information.Gastrointestinal oncology is no exception. Guidelines currently support disease site-specific testing of patients with colorectal cancer younger than 50 years and all patients with pancreatic cancer.Testing patients with esophagogastric cancer (EGC), however, currently requires a known familial variant or a strong personal or family history indicative of a hereditary cancer syndrome, such as hereditary diffuse gastric cancer or Lynch syndrome. Previous studies 1-3 that conducted panel testing of CDH1 (OMIM 192090)-negative families with a history of hereditary diffuse gastric cancer and

No abstract

91 Background: Performance status (PS) is used to predict tolerance and morbidity associated with CRC treatment. Monitoring activity level at the start of therapy using a wearable fitness tracker Fitbit (Fb) may provide a more accurate estimate of a pt’s overall PS and help predict treatment related toxicity (T). Methods: With IRB approval, we prospectively enrolled CRC pts undergoing therapy into 2 cohorts, medical undergoing chemotherapy (M) and surgical undergoing definitive surgery (S). Our objective was to assess feasibility of using Fb to track pt activity level and secondarily correlate with T. After documenting baseline ECOG PS, M and S pts wore Fb for 4 days while receiving chemotherapy or prior to surgery, respectively. Pts’ mean steps per day (SPD) were calculated excluding days Fb was worn <12 hours. To stratify prediction of toxicity risk, a cutoff of 5000 SPD was selected and any post-operative complication (S pts) or ≥grade 3 toxicity (M pts) was counted as T. The study met accrual of 80 pts. Results: On final analysis, 80 pts were evaluated for the primary aim. 68 pts had at least 3 days with ≥12 hours of Fb usage, meeting the 75% feasibility endpoint. 76 pts had at least 1 day with ≥12 hours of Fb usage with data for analysis. SPD correlated with PS and the SPD and active minutes (read by device) for PS 0 and PS 1 pts was 6313 steps and 122 min and 2925 steps and 55 min, respectively (p=0.0003). Rate of T was 25% in pts with PS 0 and 33% in pts with PS 1. With SPD, rate of T was numerically lower in pts with >5000 SPD compared to pts with <5000 SPD (21% vs 32%, p = NS). Conclusions: We observed high rates of compliance with Fb in CRC pts. SPD cutoff of 5000 correlated with ECOG PS 0 vs 1. We observed usefulness of SPD as an identifier for toxicities and suggestion that it may be more reliable compared to PS alone in this small sample of pts. These findings provide rationale to study SPD in conjunction with PS for risk stratification of pts undergoing therapy, and can possibly be incorporated into pre-habilitation selection in high risk groups. [Table: see text]