Oncogeriatric Screening In Patients With Colorectal Cancer: Is It A Good Tool For Making Decisions About Their Treatment?

e22049 Background: Colorectal cancer (CRC) is the third most common cancer worldwide. It is mostly diagnosed in elderly people, with a median age at diagnostic of 70 years. The aim of this study is to explore whether oncogeriatric screening (OS) may be helpful in decision-making about treatment. Methods: From October 2015 to June 2017, we prospectively screened 137 ≥75-years-old patients diagnosed with CRC who were referred for chemotherapy. Our OS combines 4 scales, with a positive result in ≥85-years-old patients or 75-85-years-old patients with 2 of the following criteria: G8 scale < 14, Pfeiffer > 2, Barthel index < 90 and positive TIRS scale. In addition, age, comorbidity and ECOG functional status were taken into account for final treatment decision. Results: The median age was 80.44 years (75’1 – 88’9). The most frequent diagnosis was colon cancer (71´8%) versus rectal cancer (28´2%). 47´4% of patients had metastatic disease. Whilst the OS was positive in 32´1% of cases, vulnerability ( < 14 score in G8 scale) was detected in 62% of patients. Chemotherapy was more frequently dismissed in that vulnerable patients (45´9% of G8 < 14 patients vs 28´6% of G8≥14 patients). Finally, 67 patients received chemotherapy (capecitabine 70´1%, FOLFOX 19´4%, FOLFIRI 1´5%, clinical trial 9%). Interestingly, for those patients who initiated treatment at full-dose intensity, a dose reduction was needed in 76% of G8 < 14 patients vs 28.6% of G8≥14 patients. A dose-intensity of 100% could be maintained during the whole treatment (initial and subsequent cycles) in 13% vs 33% respectively. Tolerance of the treatment also differed, with grade 3 / 4 toxicity seen in 58´69% vs 26´66% and interruption of treatment due to toxicity in 15´2% vs 6´7%, respectively. There were no toxic deaths. Conclusions: In our cohort, patients who finally did not receive chemotherapy obtained a < 14 score in G8 scale in a higher proportion. This scale identifies patients who need dose-reduction or present relevant toxicity with a greater probability. For this reason, the G8 scale is considered a helpful screening tool for decision-making in treatment for CRC in elderly patients.