108 Using the CARG prediction score to influence patient decision to proceed with chemotherapy based on the predicted incidence of toxicity in lung cancer

ABSTRACT

Introduction: The CARG (Cancer and Aging Research Group) score is a predictive model for patients 65 years and over experiencing grade 3-5 toxicity from chemotherapy. It uses factors such as the number of chemotherapeutic drugs and serological factors such as haemoglobin level. It also incorporates geriatric social factors. Studies have shown mixed results for its usefulness in Oncology practice. Methods: In this study we selected 10 suitable patients from Southend University Hospital who presented to clinic with a new diagnosis of lung cancer. If we offered chemotherapy, we calculated their CARG score and asked them if their predicted percentage of experiencing toxicity affected their decision to proceed with treatment. Results: 10/10 patients did not find the score influenced their decision. Their scores ranged from 32-50%. All patients wanted to proceed with treatment regardless of their CARG score. Participants felt that the score did not provide any additional beneficial information towards their informed decision to proceed with treatment. Conclusions: There are a number of identified flaws with the CARG score. For example, the clinician would be unlikely to offer treatment to a patient who would be at high risk of experiencing severe toxicity based in factors such as performance status. Also, the score did not take account the emergence of combination treatments with immunotherapy, which has a different toxicity profile. The study was done during the COVID-19 pandemic, which understandably has limited the social activity of elderly patients, thereby affecting their score. We conclude that the CARG score may be useful to clinicians but does not appear to influence patient decision. Disclosure No significant relationships.