PHILADELPHIA (March 17, 2020) — A recently published study led by a researcher at Fox Chase Cancer Center concluded that a combination of body mass index (BMI) and levels of albumin, a protein made by the liver, can predict how well older adults with cancer will be able to tolerate the side effects of chemotherapy.
“Oncologists should carefully consider these factors as part of a comprehensive GA [geriatric assessment] before recommended chemotherapy for older adults with cancer,” the authors wrote of their findings, which they believe are the first to document a protective effect of high BMI in this population.
The study, led by Efrat Dotan, MD, an associate professor in the Department of Hematology/Oncology, used data on 750 patients ranging from 65 to 94 years of age who were treated with chemotherapy. More than half the patients (58.6 percent) were receiving therapy for metastatic disease. The overarching goal of this large study was to identify the most important factors that affect older adults who are treated with chemotherapy for advanced cancer.
In this report, Dotan and colleagues evaluated the association between chemotherapy toxicity and nutritional factors, including pretreatment BMI, unintentional weight loss in the prior six months, and albumin levels among older adults with solid tumors.
The results showed that among older adults with advanced cancer, higher BMIs and normal albumin levels were associated with a lower risk of grade 3 or higher chemotherapy toxicity, which is graded on a scale of one to five. A score of one indicates minor toxicity and five indicates patient death, Dotan said.
“The main conclusion from this study is that monitoring patients’ BMI is important and can predict for outcomes among older cancer patients who are undergoing anti-cancer therapy,” she added.
“In this study, patients with BMI that was greater than 30 saw the highest benefit in terms of chemotherapy tolerance,” Dotan said. These findings bring into question the appropriate BMI recommendations for older adults, as BMI greater than 30 is categorized as obesity and considered unhealthy by the Centers for Disease Control and Prevention.
“Additional research is needed to define the clinical significance of nutritional markers,” Dotan said. She added that the study adds important data that provide an understanding of the associations between these nutritional factors and chemotherapy tolerance in older adults with cancer. However, limited data are available that can guide appropriate treatment selection and nutritional interventions for these patients.
The study, “Associations Between Nutritional Factors and Chemotherapy Toxicity in Older Adults With Solid Tumors,” was published in Cancer.