Development and validation of ACTTOP: a prediction model for severe anticancer treatment toxicities in older patients with solid malignancy

作者：Wing‐Lok Chan, Huiqing Hou, Cheuk‐Wai Choi, Siu-Long Thomas Yik, Ho-Fai Matthew Cheng, Wai-Lam Tsoi, Ka Man Cheung, Roger K.C. Ngan, Preston Tse, Sean Lau, Wai-Kwan Steven Siu, A. H. W. Lam, Chi‐Leung Chiang, Aya El Helali, Rachel Yuk-Ki Chu, Victor Lee, T. Yau, Kwok-Keung Yuen, Dora L.�W. Kwong · 发表于：Age and Ageing · 年份：2025 · DOI：10.1093/ageing/afaf324 · 被引用次数：3 · 研究领域：Frailty in Older Adults、Colorectal Cancer Treatments and Studies、Cancer Treatment and Pharmacology

BACKGROUND: Older adults with cancer are at increased risk of severe treatment-related toxicity (TRT). Existing chemotherapy toxicity prediction models have limitations. This study aimed to develop and validate a tool for predicting severe TRT in older patients receiving systemic anticancer therapy. METHODS: Patients aged ≥65 scheduled for systemic therapy, including chemotherapy, targeted therapy and/or immunotherapy, were recruited from three oncology centres in Hong Kong between March 2019 and June 2023. Pretreatment assessments captured clinical, tumour/treatment, laboratory and geriatric variables. Patients were monitored during treatment or for six months for grade 3-5 TRT (NCI CTCAE v5.0). Predictive factors were identified using multivariable logistic regression, and a weighted scoring system, Anti-Cancer Treatment Toxicity in Older Patients (ACTTOP), was developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and goodness-of-fit statistics, and compared with the CARG model. RESULTS: Among 700 patients (first 400 for development; last 300 for validation; median age 71), 413 (59.0%) developed grade 3-5 TRT. Ten predictors were identified. ACTTOP stratified patients into low (0-3 points: 36.0% development, 40.5% validation), intermediate (4-8 points: 63.9%, 52.5%) and high-risk (9-26 points: 86.3%, 76.6%) groups. The AUC was 0.72 (95% CI: 0.67-0.77) in development and 0.77 (95% CI: 0.72-0.82) in validation. Risk ...