Evidence map›Paper›PMID 41326760›Full record

ArticleBreast cancer research and treatment2025

Using the cancer aging and research group- breast cancer (CARG-BC) predictive model in older adults (OA) with early breast cancer: an external validation study.

Neha Pathak, Ashley Kimmel, Yael Berner-Wygoda, Sulaiman A Almuthri, Anna Theresa Santiago, Rana Jin, Susie Monginot, Shabbir M H Alibhai, Michelle B Nadler

Abstract readValidation Study
PubMed Publisher
In one paragraph

Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Neha PathakBreast Site Group, Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre (PMCC), University Health Network, University of Toronto, Toronto, Canada.ORCID http://orcid.org/0000-0003-1839-8558
Ashley KimmelMcMaster University, Hamilton, Canada.
Yael Berner-WygodaBreast Site Group, Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre (PMCC), University Health Network, University of Toronto, Toronto, Canada.
Sulaiman A AlmuthriBreast Site Group, Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre (PMCC), University Health Network, University of Toronto, Toronto, Canada.
Anna Theresa SantiagoDepartment of Biostatistics, University Health Network (UHN), Toronto, Canada.
Rana JinPrincess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
Susie MonginotPrincess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
Shabbir M H Alibhai *Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Canada.
Michelle B Nadler *Breast Site Group, Division of Medical Oncology & Hematology, Department of Medicine, Princess Margaret Cancer Centre (PMCC), University Health Network, University of Toronto, Toronto, Canada. Michelle.Nadler@uhn.ca.ORCID http://orcid.org/0000-0002-4372-3204

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDecision-making for chemotherapy in early breast cancer (EBC) in OA (older adults: age ≥ 65 years) is complex due to frailty, multimorbidity, and competing risks for mortality. Magnuson (2021) developed a chemotherapy toxicity prediction score, CARG-BC; its external validation can improve generalizability.

objectivesCARG-BC's ability to predict grade 3 + chemotoxicity in OA with EBC (primary), unplanned healthcare use, and changes to chemotherapy protocol (secondary).

methodsA single center retrospective cohort study comprising OA with EBC who received (neo) adjuvant chemotherapy from 2013-2023. Clinical, demographic, CARG-BC, and healthcare usage variables were extracted from patient records. Risk groups based on CARG-BC score were compared using T-test (continuous variables) & χ2 test (categorical variables). Toxicity risk based on CARG-BC score was assessed using logistic regression. The predictive ability of the CARG-BC score was evaluated by calculating AUC.

resultsOf 243 patients, the median age was 70 years (range 65-86), 99.6% female, 80.2% with comorbidities, 33.7% with polypharmacy, 28.8% living alone, and 8.2% seen in the geriatric oncology clinic. Over half (53.9%) had grade 3 + toxicities. Healthcare utilization included 19.8% of patients with at least one unplanned clinic visit, 29.6% an emergency care visit, and 14.4% a hospitalization. The median CARG-BC score was 7 (IQR 3, 8) and the CARG-BC AUC was 0.76 (95% Confidence interval [CI] 0.70, 0.82). The odds of grade 3 + toxicity is increased by 1.33 times per CARG-BC point increase.

conclusionThe CARG-BC model retained good discrimination for grade ≥ 3 chemotoxicity and should be used in shared-decision-making with OA.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsAgedAged, 80 and overChemotherapy, AdjuvantFemaleHumansRetrospective StudiesRisk AssessmentBreast cancerChemotherapyExternal validationGeriatric oncologyOlder adultsToxicity

Identifiers

PMID41326760

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