Computer-Generated FRAIL Score May Predict Survival in Older Adults with Multiple Myeloma

A computer-generated frailty assessment score (FRAIL score) may predict overall survival (OS) in older patients with multiple myeloma (MM), according to a study published in the Journal of Geriatric Oncology.

In this study, researchers retrospectively analyzed the FRAIL scores of 155 older patients with newly diagnosed MM who received frontline treatment with cyclophosphamide, bortezomib, and dexamethasone. They then assessed treatment outcomes using standard International Myeloma Working Group criteria and measured event-free survival (EFS) and OS.

Compared with patients who were categorized as non-frail  (FRAIL score 0-1) likely-frail patients (FRAIL score ≥2) were less likely to complete the full course of treatment (24.3% vs. 53.4%; P=0.002) and were more likely to terminate treatment due to toxicities (35.1% vs. 22.0%; P=0.109). Likely-frail patients were also more likely to stop treatment early for reasons other than toxicity or progression (27.0% vs. 10.2%; P=0.010).

After an average follow-up of 42.5 months, likely-frail patients experienced shorter EFS (median, 8.7 vs. 17.9 months; P=0.064) and inferior OS (median, 30.2 vs. 49.8 months; P<0.001) compared with non-frail patients. After adjusting for age, stage, and Charlson Comorbidity Index, the FRAIL score was a predictor for OS (hazard ratio [HR], 3.47; 95% confidence interval [CI], 1.88-6.40), but not EFS (HR, 1.28; 95% CI, 0.79-2.06).

The FRAIL score is independently predictive of OS in older patients with myeloma receiving bortezomib-based induction chemotherapy and can help identify those patients more likely to experience treatment toxicity,” the researchers concluded.