The purpose of this research study is to compare methods to help personalize the prediction of chemotherapy side effects for older adults and to evaluate whether chemotherapy causes changes in the body that are associated with aging.
Primary Objective: Describe mean and variation of the electronic frailty index-cancer, geriatric measures, patient reported outcomes, and biomarkers of aging of chemotherapy, and their change.
Study Type
OBSERVATIONAL
Enrollment
25
Eligible and consented subjects will undergo a baseline assessment prior to chemotherapy initiation inclusive of geriatric/frailty assessments, patient reported outcomes and blood samples for biomarkers of aging. Assessment measures and blood samples will be repeated post cycle 1 and 2 of chemotherapy. Toxicity will be recorded from the medical record
Wake Forest Baptist Comprehensive Cancer Center
Winston-Salem, North Carolina, United States
Resiliency Administered Assessments - Change of Short Physical Performance Battery (SPPB)
The SPPB will be used to assess lower extremity physical function (a short walk of 4 meters, timed repeated chair stands and balances tests). Each task is scored ranging from 0-4 (0 = unable to complete; 4 = highest performance level) with the total sum score range from 0-12. Lower scores indicate increased risk of disability, hospitalization and worse survival among older adults with and without cancer.
Time frame: At baseline, 3 months and 6 months after chemotherapy
Resiliency Administered Assessments - Change of Grip Strength
Grip strength in both hands will be measured using an adjustable, hydraulic grip strength dynamometer. Two trials will be conducted for each hand. Frailty by this criterion is defined by grip strength cutoffs which are dependent upon both gender and body mass index.
Time frame: At baseline, 3 months and 6 months after chemotherapy
Resiliency Administered Assessments - Change of Blessed Orientation Memory and Concentration Test (BOMC)
A 6 item test that provides a measure of cognition. For items to 1 to 3 the response is either correct (score = 0) or incorrect (score = 1). For items 4 to 6, one point is added for each error (items 4 and 5 maximum error = 2; item 6 maximum error = 5). Maximum score = 28. Participants with scores ≥ 11 will receive further evaluation or intervention as deemed medically appropriate by the treating physician.
Time frame: At baseline, 3 months and 6 months after chemotherapy
Change of Electronic Frailty Index and Cancer Score/Category
Measures collected from the resiliency assessments (Short Physical Performance Battery, Grip Strength, Blessed Orientation Memory and Concentration Test) will be used to calculate the Fried Frailty Index (FFI) to assess frailty. Scores will be anchored to the date of each assessment time point (i.e., baseline visit, follow-up visits). Each data element will be scored from 0 to 1 and the mean will be computed to calculate the overall score. Some data elements (e.g., comorbidities) will be coded as absent or present (0 or 1) and some (e.g., body mass index) will be assigned a score that ranges from 0 to 1. The higher score indicates a higher frailty of the participant.
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Time frame: At baseline, 3 months and 6 months after chemotherapy
Change in Patient Reported Outcomes Measurement - PROMIS 29
Measures collected from this is a 29-item self-reported measure including 4 items each for the following domains: physical function, anxiety, depression, fatigue, sleep disturbance, social function, and pain interference; plus 1 item measuring average pain intensity and cognition. Scoring is based on a 1-5 point Likert scale (1 = very often; 5 = never). Items are summed to create a total score that ranges from 6-30 and lower scores indicate greater self-reported difficulty.
Time frame: At baseline, 3 months and 6 months after chemotherapy
Change of Biomarkers of Aging Observed During Study Intervention
Investigators will measure targeted panels of blood-based biomarkers including but not limited to serum Interleukin-6, tumor necrosis factor receptors, growth differentiating factor 15, and cystatin C.
Time frame: At baseline, 3 months and 6 months after chemotherapy
Number of Incidences of Toxicity - Grades 2 to 5 Related to Standard of Care Chemotherapy
Grade 2 to 5 incidences of toxicities will be recorded and measured using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.
Time frame: Up to 6 months after chemotherapy
Number of Documented Dose Reductions During Chemotherapy
Participants that have the chemotherapy doses reduced during treatment will be documented.
Time frame: Up to 6 months after chemotherapy
Number of Dose Delays During Chemotherapy
Dose delays greater than three days from planned treatment will be documented.
Time frame: Up to 6 months after chemotherapy
Number of Early Discontinuations of Chemotherapy
Participants that have chemotherapy discontinued prior to anticipated completion of treatment will be documented.
Time frame: Up to 6 months after chemotherapy
Number of Unplanned Hospitalizations
Participants that required unplanned hospitalizations will be documented.
Time frame: Up to 6 months after chemotherapy
Overall Survival
Participants will be followed after completion of chemotherapy for survival status.
Time frame: Up to 6 months after chemotherapy