A new, simple and objective prognostic score for phase I cancer patients

Eur J Cancer. 2011 May;47(8):1152-60. doi: 10.1016/j.ejca.2010.12.028. Epub 2011 Feb 25.

Abstract

Aim: To ensure safety and optimise efficacy, careful patient selection for participation in oncologic phase I trials is warranted. Therefore, we did a validation study on existing phase I prognostic scores, and subsequently aimed to make an even more simple prognostic score.

Patients and methods: We retrospectively analysed characteristics and clinical outcome of 122 patients who participated in eight different phase I studies in our centre. A literature search was performed for existing prognostic scores which were validated in our dataset. Additionally, a simple prognostic score able to predict overall survival (OS), progression free survival (PFS), 90-d mortality and duration of participation was developed.

Results: In our population the median OS was 31 (range 4-241) weeks, median PFS was 10 (range 3-119) weeks. Thirteen patients (11%) died within 90-d and median participation duration was 11 (range 1-119) weeks. Two out of five existing prognostic scores could be validated in this dataset for OS. Based on multivariate analyses a new, objective and simple score, consisting of LDH, sodium and haemoglobin, was tested. High score (2-3 points) compared to low score (0-1) significantly predicted OS (HR 1.878, p = 0.003), PFS (HR 1.156, p = 0.038), participation duration (HR 1.858, p = 0.004) and 90-d mortality (OR 4.200, p = 0.022).

Conclusion: We propose a new prognostic model, using LDH, sodium and haemoglobin, helpful to predict OS, PFS, participation duration and 90-d mortality. Larger multicentre studies are needed to validate this score.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Trials, Phase I as Topic / methods*
  • Disease-Free Survival
  • Female
  • Hemoglobins / biosynthesis
  • Humans
  • Male
  • Medical Oncology / methods
  • Medical Oncology / standards*
  • Middle Aged
  • Multicenter Studies as Topic
  • Multivariate Analysis
  • Prognosis
  • Retrospective Studies
  • Sodium / blood
  • Treatment Outcome

Substances

  • Hemoglobins
  • Sodium