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The development and validation of a prediction tool for chemotherapy-induced anemia in patients with advanced nonsmall cell lung cancer receiving palliative chemotherapy

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Abstract

Background

In this study, the development and validation of a cycle-based prediction model for severe anemia [i.e., a hemoglobin (Hb) of ≤100 g/l] in patients with advanced nonsmall cell lung cancer (NSCLC) receiving palliative chemotherapy is described.

Materials and methods

Data on 536 European patients who were receiving palliative chemotherapy were prospectively collected as part of the European Cancer Anemia Survey [Ludwig et al., Eur J Cancer 40:2293–2306, 2004]. The patient sample was then randomly divided into two-thirds model derivation and one-third validation sample. A third external sample consisting of 76 patients treated at the Toronto Sunnybrook Regional Cancer Centre was separately used to externally validate the model. Multivariable logistic regression techniques were applied to develop the initial model. A risk scoring system based on the regression parameters was then created ranging from 0 to 15.

Results

Precycle Hb, patient body surface area, advanced age, poor performance status, recurrent or persistent disease, and the use of platinum or gemcitabine-based chemotherapy were identified as important predictors for anemia. A prechemotherapy risk score of ≥8 to <10 was identified as the optimal cut off to maximize the sensitivity (83.1%) and specificity (67.8%) of the prediction tool. Patients with a score of ≥8 would be considered at high risk for developing anemia after a particular cycle of chemotherapy.

Discussion

We developed and validated an anemia prediction tool for advanced stage NSCLC patients receiving palliative chemotherapy. To make the model available for easy use and access, we have incorporated it on to our risk prediction website: http://www.PredictPatientEvents.com. It is hoped that this risk model will enhance patient care by optimizing the frequency of Hb testing and/or the use of preventative therapies.

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Acknowledgements

Funding for this study was provided by an unrestricted research grant from Ortho Biotech. The corresponding author had full access to the data in the study and had the final responsibility for the decision to submit the paper.

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Authors and Affiliations

  1. London Regional Cancer Program, 790 Commissioners Road E., London, ON, N6A 4L6, Canada

    Mark Vincent

  2. Toronto Sunnybrook Regional Cancer Centre, Toronto, ON, Canada

    George Dranitsaris & Sunil Verma

  3. Ortho Biotech Inc., Toronto, ON, Canada

    Cathy Lau

  4. Hospital Clinic, Barcelona, Spain

    Pere Gascon

  5. Ghent University Hospital, Ghent, Belgium

    Simon Van Belle

  6. Wilhelminenspital, Vienna, Austria

    Heinz Ludwig

Authors
  1. Mark Vincent
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  2. George Dranitsaris
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  3. Sunil Verma
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  4. Cathy Lau
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  5. Pere Gascon
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  6. Simon Van Belle
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  7. Heinz Ludwig
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Correspondence to Mark Vincent.

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Vincent, M., Dranitsaris, G., Verma, S. et al. The development and validation of a prediction tool for chemotherapy-induced anemia in patients with advanced nonsmall cell lung cancer receiving palliative chemotherapy. Support Care Cancer 15, 265–272 (2007). https://doi.org/10.1007/s00520-006-0154-2

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  • DOI: https://doi.org/10.1007/s00520-006-0154-2

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