The National Cancer Institute has awarded Arti Hurria, M.D., associate professor in City of Hope’s Department of Medical Oncology & Therapeutics Research, a five-year, $2.6 million grant. The award funds a multicenter study aimed at determining which older breast cancer patients will tolerate chemotherapy and which will be vulnerable to significant side effects.
Arti Hurria is developing a tool to improve treatment for older cancer patients. (Photo by p.cunningham)
Side effects can interfere with a patient’s normal course of treatment, and older patients often are more vulnerable than younger patients to toxic side effects of chemotherapy, according to Hurria. There is no standard method that accurately measures the potential for toxicity in geriatric patients, however.
The study’s overall objective is to determine an older adult’s functional age — a measure that goes beyond chronological age to better gauge a patient’s readiness for treatment — so therapy can be tailored appropriately, according to Hurria.
“Our goal is to integrate both the clinical and biological characteristics of aging in order to develop an evidence-based tool that can be used in daily practice to determine the best treatment approach for older adults with breast cancer,” Hurria said.
The team will focus on older adults with breast cancer, beginning before they receive any chemotherapy and following them through treatment, Hurria said.
“We’ll also be gathering blood samples from patients prior to chemotherapy to get a baseline, and then we’ll look for any connections between pretreatment biological markers and subsequent chemotherapy side effects,” said Hurria. “This may enable us to identify biological markers of aging that can help tell us how well a patient will tolerate chemotherapy.”
A previous study by the multicenter group found that including geriatric assessment variables in the prediction model improved clinicians’ ability to predict tolerance to chemother-apy toxicity in older patients.
Geriatric assessment variables capture information about an individual’s daily functioning and activity level, age-related health conditions, cognitive function, psychological state, nutrition and level of social activity or support. Together, these factors provide the doctor with a better sense of the patient’s functional age in comparison to their chronological age, according to Hurria.
The geriatric assessment variables predicted the risk of chemotherapy toxicity, Hurria said. Those findings were presented at the 2011 annual meeting of the American Society of Clinical Oncology and published in the Journal of Clinical Oncology.
The American Cancer Society estimates that 232,620 new cases of breast cancer will be diagnosed in 2011, and people over 65 years of age accounted for almost half of those cases. Hurria’s research aims to fill a gap in addressing their needs.
“We hope that our research will help older adults with breast cancer receive the tailored and personalized treatment that they need,” she said.
City of Hope leads the multicenter research group, which includes University of Rochester Medical Center in Rochester, N.Y., Case Western Reserve University in Cleveland, Wake Forest University in Winston-Salem, N.C., Yale University of Medicine in New Haven, Conn., and Memorial Sloan-Kettering Cancer Center in New York.