Vincent et al developed a tool for predicting anemia induced by palliative chemotherapy given to a patient with advanced nonsmall cell lung cancer. This can help identify a patient who may benefit from closer monitoring or preventive therapies. The authors are from the multiple institutions in Canada and Europe as well as Ortho Biotech. Inc.
NOTE: Most these authors were involved in writing the prediction model used in the previous section.
Patient selection: advanced nonsmall lung cancer receiving palliative chemotherapy
Endpoint: anemia with hemoglobin <= 100 g/L (10 g/dL)
Parameters:
(1) hemoglobin prior to chemotherapy
(2) age in years
(3) body surface area (BSA)
(4) ECOG performance status
(5) current therapy for persistent or recurrent cancer
(6) about to receive platinum-based chemotherapy
(7) about to receive gemcitabine
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Parameter
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Finding
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Points
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|
hemoglobin prior to chemotherapy
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-0.07 * (Hgb)
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age in years
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< 68 years of age
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0
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|
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>= 68 years of age
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0.5
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|
body surface area
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>= 1.97
|
0
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|
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< 1.97
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2
|
|
ECOG performance scale
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0
|
0
|
|
|
1
|
0.5
|
|
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2 to 4
|
1
|
|
current therapy for persistent or recurrent cancer
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no
|
0
|
|
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yes
|
0.5
|
|
about to receive platinum-based chemotherapy
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no
|
0
|
|
|
yes
|
1
|
|
about to receive gemcitabine
|
no
|
0
|
|
|
yes
|
0.5
|
total score =
= SUM(points for all 7 parameters) + 13
Interpretation:
• minimum total score: 0 (to achieve this would require a hemoglobin of 18.6)
• maximum total score: 15
• The higher the score the greater the risk for developing anemia.
• A risk score between 8.0 and 9.99 was associated with the highest Youden index, with approximately 26% developing anemia.
• A risk score < 6 was associated with a very low risk of anemia.
Performance:
• A cutoff of 8.0 - 9.9 had a sensitivity of 83% with specificity of 68%.
• A cutoff of >=10 had a sensitivity of 32% with specificity of 90%.
