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1. Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer)

Author

Damien Heitz, Florence Canoui-Poitrine, Heidi Solem-Laviec, Evelyne Liuu, Anne Chah Wakilian, Hayat Medjenah, Mathilde Gisselbrecht, Catherine Cattenoz, Johanne Poisson, Rabia Boulahssass, Marie Laurent, Anne-Laure Couderc, Claire Falandry, Gilles Albrand, Romain Geiss, F. Pamoukdjian, Laure de Decker, Pascaline Boudou-Rouquette, Olivier Guillem, Elena Paillaud, Valery Antoine, Cedric Gaxatte, Claudia Martinez-Tapia, Pierre André Natella, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle de Gériatrie, CHU Strasbourg, Institut Curie - Saint Cloud (ICSC), Hôpital Antoine Charial [CHU - HCL], Hospices Civils de Lyon (HCL), AP-HP, Hôpital Européen Georges-Pompidou (HEGP), Onco-Geriatric Department, Paris, France, Assistance Publique - Hôpitaux de Marseille (APHM), Geriatric Coordination Unit for Geriatric Oncology [Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Geriatric Department, Broca Hospital, Paris Centre Hospitals, Paris Descartes University, Pôle de gérontologie [CHRU de Lille], Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), APHP, Hôpital Avicenne, Geriatric department, Coordination Unit in Geriatric Oncology, Bobigny, France, Clinical Gerontology Department, Nantes University Hospital Center, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de gériatrie, CHU Pontchaillou [Rennes], Geriatric Oncology Unit, Oncology Supportive Care Department, François Baclesse Regional Cancer Center, Caen, France, Geriatric Medicine Unite, Partenaires INRAE, AP-HP, hôpital Henri-Mondor, Clinical Research Unit (URC Mondor), F-94010 Creteil, France, and Tapia, Claudia

Subjects
Male, medicine.medical_specialty, Cachexia, Colorectal cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, Diseases of the musculoskeletal system, Elderly, [SDV.CAN] Life Sciences [q-bio]/Cancer, Interquartile range, Weight loss, Physiology (medical), Internal medicine, medicine, Prevalence, Humans, Orthopedics and Sports Medicine, Nutritional support, Aged, Gastrointestinal Neoplasms, Cancer, business.industry, QM1-695, Malnutrition, Original Articles, medicine.disease, Prognosis, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Cross-Sectional Studies, RC925-935, Geriatric oncology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Sarcopenia, Human anatomy, Screening, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, Body mass index, Prognostic value, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Background Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortality. Methods A French nationwide cross‐sectional survey (performed in 55 geriatric oncology clinics) of older cancer patients aged ≥70 referred for geriatric assessment prior to treatment choice and initiation. Demographic, clinical, and nutritional data were collected. The first outcome was cachexia, defined as loss of more than 5% of bodyweight over the previous 6 months, or a body mass index below 20 kg/m2 with weight loss of more than 2%, or sarcopenia (an impaired Strength, Assistance with walking, Rise from chair, Climb stairs and Falls score) with weight loss of more than 2%. The second outcome was 6 month overall mortality. Results Of the 1030 patients included in the analysis [median age (interquartile range): 83 (79–87); males: 48%; metastatic cancer: 42%; main cancer sites: digestive tract (29%) and breast (16%)], 534 [52% (95% confidence interval: 49–55%)] had cachexia. In the multivariate analysis, patients with breast (P

Published
2021

2. Diagnostic Performance of the 4-Item Geriatric Depression Scale for Depression Screening in Older Patients with Cancer: The ELCAPA Cohort Study

Author

Nathalie Lhuillier, Sylvie Bastuji-Garin, Charlotte Lafont, Florence Canoui-Poitrine, Cédric Lemogne, Pascaline Boudou-Rouquette, Anne Chah Wakilian, Sonia Zebachi, Olivier Hanon, Elena Paillaud, Clément Gouraud, Galdric Orvoen, François Goldwasser, Virginie Fossey-Diaz, IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Geriatric Department, Broca Hospital, Paris Centre Hospitals, Paris Descartes University, DMU Psychiatrie et Addictologie [Hôpital Corentin Celton, Issy-les-Moulineaux], Hôpital Corentin Celton [Issy-les-Moulineaux], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), GHU AP-HP Centre Université de Paris, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Bretonneau, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Cochin [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Cancer Research and Personalized Medicine - CARPEM [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Hôpital Henri Mondor, and Tapia, Claudia

Subjects
Cancer Research, medicine.medical_specialty, diagnosis, Population, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Sensitivity and Specificity, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, Mass Screening, 030212 general & internal medicine, education, Geriatric Assessment, Depression (differential diagnoses), Early Detection of Cancer, Aged, 80 and over, education.field_of_study, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, Psychiatric assessment, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, psychiatric status rating scales, Cancer, medicine.disease, aged, Geriatric Oncology, Cross-Sectional Studies, Oncology, Geriatric oncology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cohort, depression, Geriatric Depression Scale, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Cohort study
Abstract

Background In older patients with cancer, depression is difficult to assess because of its heterogeneous clinical expression. The 4-item version of the Geriatric Depression Scale (GDS-4) is quick and easy to administer but has not been validated in this population. The present study was designed to test the diagnostic performance of the GDS-4 in a French cohort of older patients with cancer before treatment. Materials and Methods Our cross-sectional analysis of data from the Elderly Cancer Patient cohort covered all patients with cancer aged ≥70 years and referred for geriatric assessment at two centers in France between 2007 and 2018. The GDS-4’s psychometric properties were evaluated against three different measures of depression: the geriatrician's clinical diagnosis (based on a semistructured interview), the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, and a cluster analysis. The scale's sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver operating characteristic curve (AUROC) were calculated. Results In a sample of 2,293 patients (median age, 81 years; women, 46%), the GDS-4’s sensitivity and specificity for detecting physician-diagnosed depression were, respectively, 90% and 89%. The positive and negative likelihood ratios were 8.2 and 0.11, and the AUROC was 92%. When considering the subset of patients with data on all measures of depression, the sensitivity and specificity values were, respectively, ≥90% and ≥72%, the positive and negative likelihood ratios were, respectively, ≥3.4 and ≤ 0.11, and the AUROC was ≥91%. Conclusion The GDS-4 appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer. Implications for Practice Considering the overlap between symptoms of cancer and symptoms of depression, depression is particularly difficult to assess in older geriatric oncology and is associated with poor outcomes; there is a need for a routine psychological screening. Self-report instruments like the 4-item version of the Geriatric Depression Scale appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer. Asking four questions might enable physicians to screen older patients with cancer for depression and then guide them toward further clinical evaluation and appropriate care if required.

Published
2021

3. Potential drug–drug interactions with abiraterone in metastatic castration-resistant prostate cancer patients: a prevalence study in France

Author

François Goldwasser, Audrey Thomas-Schoemann, Galdric Orvoen, Jean-Louis Golmard, Olivier Huillard, Benoit Blanchet, Pascaline Boudou-Rouquette, Clémentine Villeminey, Anne Chah Wakilian, Michel Vidal, Esther Azoulay-Rutman, Clément Bonnet, Jérôme Alexandre, Edith Carton, and Gaëlle Noé

Subjects
Male, Oncology, Cancer Research, Comorbidity, Pharmacists, Toxicology, 030226 pharmacology & pharmacy, chemistry.chemical_compound, Prostate cancer, 0302 clinical medicine, immune system diseases, Prednisone, Prevalence, Electronic Health Records, Drug Interactions, heterocyclic compounds, Pharmacology (medical), Enzyme Inhibitors, Neoplasm Metastasis, media_common, Aged, 80 and over, Univariate analysis, Abiraterone acetate, virus diseases, Prostatic Neoplasms, Castration-Resistant, 030220 oncology & carcinogenesis, Androstenes, France, medicine.drug, Drug, medicine.medical_specialty, media_common.quotation_subject, Pain, Disease-Free Survival, 03 medical and health sciences, Internal medicine, parasitic diseases, medicine, Humans, Aged, Retrospective Studies, Pharmacology, Polypharmacy, business.industry, Retrospective cohort study, biochemical phenomena, metabolism, and nutrition, medicine.disease, Cross-Sectional Studies, chemistry, business
Abstract

Abiraterone acetate combined with prednisone improves survival in metastatic castration-resistant prostate cancer (mCRPC) patients. This oral anticancer agent may result in drug–drug interactions (DDI). We aimed to evaluate the prevalence of DDI with abiraterone and the possible determinants for the occurrence of these DDI. We performed a single centre retrospective review from electronic medical records of mCRPC patients treated with abiraterone from 2011 to 2015. Potential DDI with abiraterone were identified using Micromedex and were categorized by a 4-point scale severity. Seventy-two out of ninety-five mCRPC pts (median age: 77 years [68–82]) had comorbidities. The median number of drugs used per patient was 7 [5–9]. 66 potential DDI with abiraterone were detected in 49 patients (52%): 39 and 61% were classified as major and moderate DDI, respectively. In the univariate analysis, pain (p

Published
2017

4. Diagnostic Performance of the 4‐Item Geriatric Depression Scale for Depression Screening in Older Patients with Cancer: The ELCAPA Cohort Study.

Author

Lafont, Charlotte, Chah Wakilian, Anne, Lemogne, Cédric, Gouraud, Clément, Fossey‐Diaz, Virginie, Orvoen, Galdric, Lhuillier, Nathalie, Paillaud, Elena, Bastuji‐Garin, Sylvie, Zebachi, Sonia, Hanon, Olivier, Goldwasser, François, Boudou‐Rouquette, Pascaline, and Canouï‐Poitrine, Florence

Subjects
DIAGNOSIS of mental depression, CROSS-sectional method, GERIATRIC assessment, CANCER patients, PSYCHOMETRICS, DESCRIPTIVE statistics, RECEIVER operating characteristic curves, CLUSTER analysis (Statistics), OLD age
Abstract

Background: In older patients with cancer, depression is difficult to assess because of its heterogeneous clinical expression. The 4‐item version of the Geriatric Depression Scale (GDS‐4) is quick and easy to administer but has not been validated in this population. The present study was designed to test the diagnostic performance of the GDS‐4 in a French cohort of older patients with cancer before treatment. Materials and Methods: Our cross‐sectional analysis of data from the Elderly Cancer Patient cohort covered all patients with cancer aged ≥70 years and referred for geriatric assessment at two centers in France between 2007 and 2018. The GDS‐4's psychometric properties were evaluated against three different measures of depression: the geriatrician's clinical diagnosis (based on a semistructured interview), the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, and a cluster analysis. The scale's sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver operating characteristic curve (AUROC) were calculated. Results: In a sample of 2,293 patients (median age, 81 years; women, 46%), the GDS‐4's sensitivity and specificity for detecting physician‐diagnosed depression were, respectively, 90% and 89%. The positive and negative likelihood ratios were 8.2 and 0.11, and the AUROC was 92%. When considering the subset of patients with data on all measures of depression, the sensitivity and specificity values were, respectively, ≥90% and ≥72%, the positive and negative likelihood ratios were, respectively, ≥3.4 and ≤ 0.11, and the AUROC was ≥91%. Conclusion: The GDS‐4 appears to be a clinically relevant, easy‐to‐use tool for routine depression screening in older patients with cancer. Implications for Practice: Considering the overlap between symptoms of cancer and symptoms of depression, depression is particularly difficult to assess in older geriatric oncology and is associated with poor outcomes; there is a need for a routine psychological screening. Self‐report instruments like the 4‐item version of the Geriatric Depression Scale appears to be a clinically relevant, easy‐to‐use tool for routine depression screening in older patients with cancer. Asking four questions might enable physicians to screen older patients with cancer for depression and then guide them toward further clinical evaluation and appropriate care if required. Depression is associated with worse outcomes in older patients with cancer. This article evaluates the diagnostic performance of the French Geriatric Depression Scale (GDS‐4) in a French cohort of elderly patients before treatment for cancer. [ABSTRACT FROM AUTHOR]

Published
2021
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