A post hoc analysis of the EPAZ trial: The role of geriatric variables in elderly soft tissue sarcoma patients on toxicity and outcome

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Rainer Hamacher - , Universität Duisburg-Essen (Autor:in)
  • Xiaofei Liu - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Markus K. Schuler - , Technische Universität Dresden (Autor:in)
  • Leopold Hentschel - , Universitäts KrebsCentrum Dresden (Autor:in)
  • Patrick Schöffski - , KU Leuven (Autor:in)
  • Hans Georg Kopp - , Robert Bosch GmbH (Autor:in)
  • Sebastian Bauer - , Universität Duisburg-Essen (Autor:in)
  • Bernd Kasper - , Universität Heidelberg (Autor:in)
  • Lars Lindner - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Jens Markus Chemnitz - , Community Hospital Middle Rine, Universität zu Köln (Autor:in)
  • Martina Crysandt - , Rheinisch-Westfälische Technische Hochschule Aachen (Autor:in)
  • Alexander Stein - , Universität Hamburg (Autor:in)
  • Björn Steffen - , Universitätsklinikum Frankfurt (Autor:in)
  • Stephan Richter - , Nationales Centrum für Tumorerkrankungen Dresden (Autor:in)
  • Gerlinde Egerer - , Universität Heidelberg (Autor:in)
  • Philipp Ivanyi - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Annegret Kunitz - , Vivantes Klinikum Spandau , Charité – Universitätsmedizin Berlin (Autor:in)
  • Viktor Grünwald - , Universität Duisburg-Essen (Autor:in)

Abstract

Objective: The EPAZ study (NCT01861951) showed recently that pazopanib was non-inferior to doxorubicin in patients ≥60 years treated in first line for advanced soft tissue sarcoma . The current post-hoc analysis aimed to assess the prognostic impact of frailty. Methods: Geriatric assessments were evaluated at baseline. Age >75 years, liposarcoma, ECOG = 2, G8 ≤14, instrumental activities of daily living (IADL) ≥1 and Charlson Comorbidity Index ≥2 were tested for their impact on progression-free survival (PFS), overall survival (OS), CTCAE grade 3/4 adverse events (AEs) or serious AEs (SAEs), using univariate and multivariate analysis models. Results: univariate analysis showed an increased risk of grade 3/4 AEs and SAEs for ECOG = 2, G8 score ≤14 or IADL ≥1, independent of treatment. The multivariate analysis exhibited for pazopanib a significantly reduced risk for grade 3/4 AEs (HR 0.53; p = 0.033), and in patients with G8 ≤14 an increased risk for SAEs (HR 2.67; p = 0.011). In the multivariate analysis, G8 ≤14 was a negative prognostic factor for PFS (HR 1.82; p = 0.009) and IADL ≥1 for OS (HR 2.02; p = 0.007). ECOG = 2 was the strongest negative predictor for PFS (HR 4.39; p = 0.001) and OS (HR 3.74; p = 0.004). Neither age nor Charlson Comorbidity Index showed any impact on PFS, OS, incidence of grade 3/4 AEs or SAEs. Conclusions: This post hoc analysis demonstrated that age is not a denominator for outcome or toxicity in elderly patients with soft tissue sarcoma . Instead, geriatric and functional assessments should be used to counsel patients and tailor therapy to individual needs. Moreover, pazopanib has a reduced risk for grade 3/4 AEs compared to doxorubicin. © 2022 Elsevier Ltd

Details

OriginalspracheEnglisch
Seiten (von - bis)145-154
Seitenumfang10
FachzeitschriftEuropean journal of cancer
Jahrgang181
PublikationsstatusVeröffentlicht - März 2023
Peer-Review-StatusJa

Externe IDs

PubMed 36657323

Schlagworte

Ziele für nachhaltige Entwicklung

ASJC Scopus Sachgebiete

Schlagwörter

  • Doxorubicin, EPAZ, Elderly, Frailty, Geriatric, Pazopanib, Post–hoc, Prognosis, Soft tissue sarcoma, Toxicity, Doxorubicin/adverse effects, Humans, Indazoles/adverse effects, Sarcoma/drug therapy, Activities of Daily Living, Soft Tissue Neoplasms, Aged

Bibliotheksschlagworte