Oncogeriatric Screening and Evaluation Program (PROTEGER)
PROgrama de Tamizaje y Evaluación oncoGERiátrica
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Cancer incidence increases significantly with age, and up to 70% of cancer mortality occurs in patients aged 65 years or older. Despite this, older patients are frequently undertreated due to the high risk of secondary toxicity, which is associated with quality of life deterioration, increased hospitalizations, and higher mortality. Comprehensive Geriatric Assessment (CGA) has proven to be an effective tool to identify vulnerability, reduce chemotherapy-related toxicity, and tailor interventions. However, the lack of geriatricians, especially in Latin American public health systems, creates significant barriers to accessing CGA-guided oncological care.
To overcome these barriers, the PROTEGER program proposes an innovative digital health solution by developing and validating a machine learning-based clinical decision support system (CDSS) for oncogeriatric care. The study is an observational, multicenter, bidirectional cohort study conducted in two phases:
Phase 1: Retrospective Training Phase This phase uses anonymized clinical data (2021-2023) from the Oncogeriatric Tele-Committee of the Chilean Ministry of Health's Digital Hospital. Data from older patients with solid tumors who underwent a CGA will be used to train and test predictive models using machine learning techniques (e.g., Gradient Boosting Trees and Random Forest) following the CRISP-DM methodology. The predictive model aims to learn the Committee's treatment recommendation patterns based on patient functionality, comorbidities, and geriatric syndromes.
Phase 2: Prospective Validation Phase A prospective, multicenter cohort will be enrolled across healthcare centers in Chile, Peru, and Brazil. Eligible patients (aged 65+ with a solid tumor diagnosis) who undergo routine CGA and oncological care will be followed for 6 months. Data regarding baseline characteristics, treatment decisions (made by local oncology teams blinded to the AI model's recommendation), dose reductions, treatment discontinuation, disease progression, quality of life (EORTC QLQ-C30 and ELD14), and survival will be collected.
Study Objectives:
The primary objective is to develop, train, and clinically validate the PROTEGER machine learning predictive model to provide an accurate treatment recommendation (e.g., standard treatment, dose-adjusted treatment, or supportive care only) capable of assisting clinical decision-making by oncology teams. A secondary objective involves the design and development of an intuitive graphical user interface capable of being used by healthcare providers and patients for data management and result interpretation.
All predictive models will be evaluated using standard metrics, such as the Area Under the ROC Curve (AUC) and the C-statistic, to determine their discriminatory capacity in a real-world clinical setting.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Project Manager
- Phone Number: +55 51 3384 5334
- Email: lacog0325@lacog.group
Study Contact Backup
- Name: Head of Clinical Operations
- Phone Number: +55 (51) 3384.5334
- Email: laura.voelcker@lacog.group
Study Locations
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São Paulo
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São Paulo, São Paulo, Brazil, 05653-000
- HIAE - Hospital Israelita Albert Einstein
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Principal Investigator:
- Ludmila de Oliveira Muniz Koch
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São Paulo, São Paulo, Brazil, 04004-060
- BR192 HCOR - Hospital do Coração
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Principal Investigator:
- Luciola Pontes Leite de Barros
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age 65 years or older.
- Diagnosis of solid tumor cancer.
- Must have been evaluated and followed up by a local oncology team.
- Signed Informed Consent Form (ICF) applied in accordance with the local ethics committee.
- Must have undergone a Comprehensive Geriatric Assessment (CGA).
Exclusion Criteria:
- Patients who are unable or unwilling to consent to providing information will be excluded.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
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Retrospective Training Cohort (Chile)
Anonymized data from cases submitted to the Oncogeriatrics Telecommittee from 2021 to the end of 2023, obtained from the Chilean Ministry of Health's Digital Hospital database, along with patient survival data, will be used to train and validate the predictive model using machine learning techniques.
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Prospective Validation Cohort (Chile, Brasil, Peru)
Older adults with cancer receive a comprehensive geriatric assessment at their respective centers and are introduced to an oncogeriatric team.
They will share their baseline characteristics, the results of their CGA, clinical data related to cancer treatment, and 3- and 6-month follow-up for the development and validation of a predictive model using machine learning techniques.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Predictive Accuracy of the PROTEGER Machine Learning Model
Time Frame: Up to 6 months post-enrollment.
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Discrimination performance of the machine learning predictive model in recommending oncogeriatric treatment decisions (standard treatment, dose-adjusted treatment, or supportive care/no treatment) based on Comprehensive Geriatric Assessment (CGA) data, measured by the Area Under the Receiver Operating Characteristic Curve (AUC-ROC), with scores ranging from 0.5 (no discrimination/chance) to 1.0 (perfect discrimination).
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Up to 6 months post-enrollment.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of High-Grade Chemotherapy-Related Adverse Events
Time Frame: At 3 and 6 months post-enrollment.
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Percentage of participants experiencing Grade 3 or higher toxicities/adverse reactions evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
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At 3 and 6 months post-enrollment.
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General Quality of Life Score (EORTC QLQ-C30)
Time Frame: Baseline, 3 months, and 6 months post-enrollment.
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Global health status and quality of life assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30).
Scores range from 0 to 100, where higher scores represent a better overall quality of life and higher functioning.
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Baseline, 3 months, and 6 months post-enrollment.
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Elderly-Specific Quality of Life Score (EORTC QLQ-ELD14)
Time Frame: Baseline, 3 months, and 6 months post-enrollment.
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Elderly-specific quality of life issues assessed using the EORTC QLQ-ELD14 module.
Scores range from 0 to 100.
For symptom scales, higher scores represent worse outcomes (higher level of symptoms/problems); for functional scales, higher scores represent better outcomes.
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Baseline, 3 months, and 6 months post-enrollment.
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Incidence of Hospitalizations
Time Frame: At 3 and 6 months post-enrollment.
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Number of patients requiring unplanned hospital admissions during the treatment course
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At 3 and 6 months post-enrollment.
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Treatment Discontinuation and Dose Reduction Rates
Time Frame: At 3 and 6 months post-enrollment.
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Percentage of patients undergoing chemotherapy dose reductions (planned vs. received dose) or early treatment discontinuation.
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At 3 and 6 months post-enrollment.
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Patient Survival and Disease Progression
Time Frame: At 3 and 6 months post-enrollment.
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Overall survival status and disease progression rate assessed according to RECIST 1.0 criteria.
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At 3 and 6 months post-enrollment.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Luciola Pontes Leite de Barros, Hospital do Coração (HCOR)
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- LACOG 0325
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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