Validity of the Cancer and Aging Research Group Predictive Tool in Older Japanese Patients

Simple Summary This study aimed to assess the usefulness of the Cancer and Aging Research Group (CARG) predictive tool in predicting chemotherapy-related adverse events (CRAEs) in elderly Japanese patients with cancer. The CARG has developed a very useful tool that can predict CRAEs among patients with solid tumors aged above 65 years. However, considering that this tool is based on data from Europe and the United States, the usefulness of the tool for Japanese people, who have different sensitivities to anticancer drugs and varying life expectancies, is still unknown. This study showed that the CARG tool could help predict CRAEs in elderly Japanese patients with cancer, i.e., this tool has the potential to optimize chemotherapy in elderly Japanese patients with cancer. Background: This study aimed to evaluate the usefulness of the Cancer and Aging Research Group (CARG) predictive tool in older Japanese patients with cancer. Methods: Patients aged 65 years or older with solid tumors treated with new anticancer regimens in Kakogawa Central City Hospital between April 2016 and March 2019 were included. Grade 3 or higher risks of developing chemotherapy-related adverse events (CRAEs) were calculated using the tool (low-, intermediate-, or high-risk scores). The association between grade 3-5 CRAE incidence during the first course of each regimen and the calculated risk or the patient characteristics was evaluated. The difference in the incidences of CRAEs between the groups was evaluated by Fisher's exact test. Results: This study examined 76 patients (mean age: 71 (65-82) years). The incidence of grade 3-5 CRAE was 38%, 55%, and 76% in patients classified as low, medium, and high CARG risk scores (p = 0.035), and the incidence of severe non-hematological toxicities was 4%, 31%, and 52% (p < 0.01), respectively. Eastern Cooperative Oncology Group performance status and age were not associated with chemotherapy toxicity. Conclusions: The CARG predictive tool was valid, suggesting its usefulness in optimizing chemotherapy outcomes in older patients with cancer.