PDF(Pubmed)
Abstract：
UNASSIGNED: Older adults with chronic disease prioritize functional independence. We aimed to describe the feasibility of capturing functional disability and treatment toxicity among older adults with lung cancer using a longitudinal comprehensive geriatric assessment (CGA) and molecular biomarkers of aging.
UNASSIGNED: This prospective study included adults ≥60 years with any newly diagnosed non-small-cell lung cancer. Participants were recruited from central Ohio (2018-2020). Study assessments included the Cancer and Aging Research Group CGA (CARG-CGA), short physical performance battery (SPPB), and the blessed orientation-memory concentration (BOMC) test at baseline, 3, 6, and 12 months. Activities of daily living (ADLs) and instrumental ADLs (IADLs), quality of life (QoL, PROMIS 10), and treatment toxicity were captured monthly. Stool and blood were collected to characterize the gut microbiome and age-related blood biomarkers.
UNASSIGNED: This study enrolled 50 participants with an average age of 71.7 years. Ninety-two percent of participants were Caucasian, 58% were male, and all were non-Hispanic. Most had advanced stage (stage III/IV: 90%; stage I/II: 10%), with adenocarcinoma the predominant histologic subtype (68% vs. 24% squamous). First-line treatments included chemotherapy (44%), immune checkpoint inhibitors (ICIs, 22%), chemotherapy and ICIs (30%), or tyrosine kinase inhibitors (4%). The median baseline CARG toxicity score was 8 (range 2-12). Among patients with treatment-related toxicity (n = 49), 39 (79.6%) cases were mild (grade 1-2), and 10 (20.4%) were moderate to severe (≥ grade 3). Treatment toxicity was greater among those with a CARG score ≥8 (28.0% vs. 13.6%). Higher IADL independence, QoL, and SPPB scores at baseline were positively associated with Candidatus Gastranaerophilales bacterium, Lactobacillus rogosae, and Enterobacteria phage P4. Romboutsia ilealis, Streptococcus, and Lachnoclostridium sp An138 and T cell lag3 and cd8a were associated with worse IADLs, QoL, and SPPB scores at baseline.
UNASSIGNED: A longitudinal CGA and biomarker collection is feasible among older adults undergoing lung cancer treatment. Gut microbe and T cell gene expression changes correlated with subjective and objective functional status assessments. Future research will test causality in these associations to improve outcomes through novel supportive care interventions to prevent functional disability.
UNASSIGNED: This prospective study included adults ≥60 years with any newly diagnosed non-small-cell lung cancer. Participants were recruited from central Ohio (2018-2020). Study assessments included the Cancer and Aging Research Group CGA (CARG-CGA), short physical performance battery (SPPB), and the blessed orientation-memory concentration (BOMC) test at baseline, 3, 6, and 12 months. Activities of daily living (ADLs) and instrumental ADLs (IADLs), quality of life (QoL, PROMIS 10), and treatment toxicity were captured monthly. Stool and blood were collected to characterize the gut microbiome and age-related blood biomarkers.
UNASSIGNED: This study enrolled 50 participants with an average age of 71.7 years. Ninety-two percent of participants were Caucasian, 58% were male, and all were non-Hispanic. Most had advanced stage (stage III/IV: 90%; stage I/II: 10%), with adenocarcinoma the predominant histologic subtype (68% vs. 24% squamous). First-line treatments included chemotherapy (44%), immune checkpoint inhibitors (ICIs, 22%), chemotherapy and ICIs (30%), or tyrosine kinase inhibitors (4%). The median baseline CARG toxicity score was 8 (range 2-12). Among patients with treatment-related toxicity (n = 49), 39 (79.6%) cases were mild (grade 1-2), and 10 (20.4%) were moderate to severe (≥ grade 3). Treatment toxicity was greater among those with a CARG score ≥8 (28.0% vs. 13.6%). Higher IADL independence, QoL, and SPPB scores at baseline were positively associated with Candidatus Gastranaerophilales bacterium, Lactobacillus rogosae, and Enterobacteria phage P4. Romboutsia ilealis, Streptococcus, and Lachnoclostridium sp An138 and T cell lag3 and cd8a were associated with worse IADLs, QoL, and SPPB scores at baseline.
UNASSIGNED: A longitudinal CGA and biomarker collection is feasible among older adults undergoing lung cancer treatment. Gut microbe and T cell gene expression changes correlated with subjective and objective functional status assessments. Future research will test causality in these associations to improve outcomes through novel supportive care interventions to prevent functional disability.
摘要：
■患有慢性病的老年人优先考虑功能独立性。我们旨在通过纵向综合老年评估（CGA）和衰老的分子生物标志物来描述在患有肺癌的老年人中捕获功能性残疾和治疗毒性的可行性。
■这项前瞻性研究纳入了新诊断为非小细胞肺癌的≥60岁成年人。参与者来自俄亥俄州中部（2018-2020年）。研究评估包括癌症和衰老研究小组CGA（CARG-CGA），短物理性能电池（SPPB），和基线时的祝福定向记忆浓度(BOMC)测试，3、6和12个月。日常生活活动(ADL)和工具性ADL(IADL)，生活质量(QoL，PROMIS10)，每月捕获治疗毒性。收集粪便和血液以表征肠道微生物组和年龄相关的血液生物标志物。
■这项研究招募了50名参与者，平均年龄为71.7岁。92%的参与者是白种人，58%是男性，而且都是非西班牙裔.大多数有晚期阶段（III/IV期：90％；I/II期：10％），腺癌是主要的组织学亚型(68%vs.24%鳞状）。一线治疗包括化疗（44%），免疫检查点抑制剂(ICIs，22%），化疗和ICIs（30%），或酪氨酸激酶抑制剂（4％）。基线CARG毒性评分中位数为8(范围2-12)。在治疗相关毒性的患者中（n=49），39例（79.6%）为轻度（1-2级），10例（20.4%）为中度至重度（≥3级）。CARG评分≥8的患者的治疗毒性更大（28.0%vs.13.6%）。较高的IADL独立性，QoL,和SPPB评分在基线与念珠菌呈正相关，玫瑰乳杆菌,和肠杆菌噬菌体P4。回肠Romboutsia,链球菌,和Lachnoctrdiumsp。An138和T细胞lag3和cd8a与较差的IADLs相关，QoL,和基线时的SPPB得分。
■纵向CGA和生物标志物收集在接受肺癌治疗的老年人中是可行的。肠道微生物和T细胞基因表达变化与主观和客观功能状态评估相关。未来的研究将测试这些关联中的因果关系，以通过新的支持性护理干预措施来预防功能障碍来改善结果。
■这项前瞻性研究纳入了新诊断为非小细胞肺癌的≥60岁成年人。参与者来自俄亥俄州中部（2018-2020年）。研究评估包括癌症和衰老研究小组CGA（CARG-CGA），短物理性能电池（SPPB），和基线时的祝福定向记忆浓度(BOMC)测试，3、6和12个月。日常生活活动(ADL)和工具性ADL(IADL)，生活质量(QoL，PROMIS10)，每月捕获治疗毒性。收集粪便和血液以表征肠道微生物组和年龄相关的血液生物标志物。
■这项研究招募了50名参与者，平均年龄为71.7岁。92%的参与者是白种人，58%是男性，而且都是非西班牙裔.大多数有晚期阶段（III/IV期：90％；I/II期：10％），腺癌是主要的组织学亚型(68%vs.24%鳞状）。一线治疗包括化疗（44%），免疫检查点抑制剂(ICIs，22%），化疗和ICIs（30%），或酪氨酸激酶抑制剂（4％）。基线CARG毒性评分中位数为8(范围2-12)。在治疗相关毒性的患者中（n=49），39例（79.6%）为轻度（1-2级），10例（20.4%）为中度至重度（≥3级）。CARG评分≥8的患者的治疗毒性更大（28.0%vs.13.6%）。较高的IADL独立性，QoL,和SPPB评分在基线与念珠菌呈正相关，玫瑰乳杆菌,和肠杆菌噬菌体P4。回肠Romboutsia,链球菌,和Lachnoctrdiumsp。An138和T细胞lag3和cd8a与较差的IADLs相关，QoL,和基线时的SPPB得分。
■纵向CGA和生物标志物收集在接受肺癌治疗的老年人中是可行的。肠道微生物和T细胞基因表达变化与主观和客观功能状态评估相关。未来的研究将测试这些关联中的因果关系，以通过新的支持性护理干预措施来预防功能障碍来改善结果。
