Table 3.

Chemotherapy studies in the elderly population

Abbreviations: AUC, area under the curve; ECOG PS, eastern cooperative oncology group performance status; OS, overall survival; PFS, progression-free survival; GVS, geriatric vulnerability score; IADL, instrumental activities of daily living

GA Tool	Domains assessed	Comments
C-SGA. SAKK cancer-specific geriatric assessment [99]	Age-adjusted Charlson Comorbidity Index (CCI) Vulnerable Elders Survey (VES-13) Geriatric Depression Score (GDS-5) Modified MOS – Social Support Survey (mMOS-SS) Mini-Cog	Feasibility study. Mean time for pt. to complete questionnaire - 17.33 ±7.34 vs. 20.59 ± 6.53 minutes for physicians No biochemical/laboratory based parameters No assessment of correlation between toxicity/mortality, only feasibility of completion.
GAH. Geriatric Assessment in Hematology [100].	Number of drugs Gait speed Depression score (single-question) 3 ADL questions (from VES-13) Subjective health status 4 items from MNA-SF (BMI, Weight loss during last 3 months, food intake decline over past 3 months, psychological stress/acute disease SPMSQ (short portable mental status questionnaire) Prognostic index for 4-year mortality in Older adults	363 patients newly diagnosed with haematological malignancies. Internally validated and reproducible. Not validated in solid-organ malignancies Mean time to complete 11.9 +/- 4.7 min
CRASH The chemotherapy Risk Assessment Scale for High-Age patients [25]	Haematological Toxicity: Diastolic BP IADL LDH Chemotox score (scoring System 0-2 based on relative toxicity; for example, carboplatin/pemetrexed = 1) Non-Haematological Toxicity: ECOG Performance status MMSE MNA Chemotox score	460 patients. Valid across a large number of chemotherapy regimens Incorporation of potential toxicity of treatment into the risk scoring (MAX2 index). Predictive for toxicity
G8 [68]	Nutritional (derived from MNA) Weight loss during last 3 months Mobility Neuropsychological/Dementia BMI Polypharmacy (>3 drugs/day) Patient comparison of health status compared to others of their age Age	Validated first as a surrogate for CGA. 202 patients over the age of 65 included with self-completed questionnaires across all tumour types. Patients with a low G8 score of ≤14 were more likely to experience severe chemotherapy toxicity than those with a high G8 score: 64.6% vs.46.9% (χ2=5.029, p=0.025)
CARG [63]	1. Age: > 72 years 2. Cancer type: GI or genitourinary 3. N˚ of chemotherapy drugs: polychemotherapy 4. Chemotherapy dosing: standard dose 5. Hemoglobin: <11 g/dL (male); <10 g/dL (female) 6. Creatinine clearance: <34 mL/min (Jelliffe, ideal weight) 7. Hearing: fair or worse 8. N˚ of falls in the last 6 months: ≥ 1 9. IADL: taking medications with some help or unable to take medication 10. Walking one block: somewhat limited or limited a lot 11. Decreased social activity because of physical and/or emotional health:	Predictive score derived from prospective analysis of 500 patients over the age of 65 with various cancers. Mean age 73. Low (0-5) Intermediate (6-9) and High (10-19). Predictive for chemotherapy related toxicity.
GVS/GINECO[80]	Age ECOG Performance status Hypoalbuminaemia Lymphopaenia Functional: ADL, IADL Depression: HADS	Predictive for chemotherapy related toxicity. Deficit in 3 or more covariates results in a RR of mortality of 2.94.