Abstract P4-16-01: Feasibility of comprehensive geriatric assessment in an academic breast oncology clinic

Abstract

Introduction: Adults age ≥65y constitute the majority of patients (pts) diagnosed with cancer. There is a gap in knowledge about the safest and most effect cancer treatments for older pts. At The Ohio State University, we have a longitudinal multidisciplinary geriatric clinic for adults ≥ 65 years of age diagnosed with breast cancer (BC). The clinic team consists of a physician, nurse practitioner, dietician, physical therapist, social worker nurse, and pharmacist. We evaluate the unique needs of older pts with breast cancer by completing a comprehensive geriatric assessment (CGA). Eligible patients are enrolled into OSU-16153 which is a is prospective cohort study of pts ≥65y with new diagnosis of BC to better understand complex health issues of this population, and to collect data to support future studies. Methods: Forty eight pts have completed the baseline questionnaires including demographics, lifestyle and health history and CGA. Summary statistics were used to describe the baseline characteristics. Results: The median age of patients enrolled in the study was 77 years (range 67-94), the mean BMI was 28, 50% (24/48) were Caucasian and 6% (3/48) were African American. Mobility was assessed mobility with the time get up and go (TGUG), mean 9.8 (SD=6.2) and grip strength, mean of 31. Cognitive limitations were screened with the blessed orientation memory concentration test, mean 3.9 (SD=5.0) and mini-cog, mean 3.6 (SD=1), malnutrition, mean 12.3 (SD=12.2) and depression, mean 1.6 (SD=2.4). Functional limitations were measured with Katz, mean 5.9 (SD=0.2), and Lawson, mean 7.8 (SD=0.8). Disease characteristics included 18% (9/48) Tis, 54% (26/48) T1, 21% (10/48) T2, 2%(1/48) T3, and 4% (2/48) T4 tumors, 65% (31/48) lymph node negative and 81% (39/48) estrogen positive (ER+),17% (8/48) ER negative and 4% (2/48) HER2 positive. Oncotype score was <25 in 19% (9/48) and >25 in 4% (2/48). Twelve percent (6/48) received adjuvant chemotherapy for triple negative or ER+ breast cancer with high oncotype with docetaxel/cytoxan and 4% received trastuzumab based therapy and they were able to complete all planned cycles. Two pts received chemotherapy based on results of CGA. Forty-two pts were eligible to receive endocrine therapy (ET); 3 pts with ductal carcinoma in-situ (DCIS) and 2 pts with invasive BC declined, 1 did not follow up after her initial visit. Five pts switched ET due to side effects. The 7 patients with invasive BC who declined or switched ET due to side effects all had an abnormal TGUG, 43% (3/7) had an impaired min-cog and 57% (4/7) had impaired hand grip. Conclusions: The majority of older adults have no functional deficits in ADL/IADL, have adequate mobility and grip strength and did not screen positive for cognitive limitations, depression or, malnutrition. Our data shows that the mobility and cognitive assessment of a CGA may serve as a predictor of toxicity from ET therapy and identify patients who are at risk for side effects and who may benefit from additional interventions. The majority of pts who received adjuvant chemotherapy and ET tolerated well. Our pilot data shows a CGA is feasible and that a CGA helped direct appropriate therapy. Citation Format: Nicole Williams, Julie Stephens, Elizabeth Kress, Erin Frey, Susan Fugett, Paige Erdeljac, Stephanie Yager, Erin Holley, Cari Utendorf, Nikki Ford, Caitln Ubbing, Jeanie Overcash, Bhuvaneswari Ramaswamy, Anne Noonan. Feasibility of comprehensive geriatric assessment in an academic breast oncology clinic [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-16-01.