Oncogeriatric Screening and Evaluation Program (PROTEGER)

September 1, 2026 updated by: Latin American Cooperative Oncology Group

PROgrama de Tamizaje y Evaluación oncoGERiátrica

This study aims to develop, train, and validate a machine learning-based prediction model (PROTEGER) to provide treatment decision recommendations for older adults diagnosed with solid tumor cancers. The study has a two-phase observational design: a retrospective cohort using anonymized data from an oncogeriatric telecommittee to train the predictive model, followed by a prospective multicenter cohort across Chile, Peru, and Brazil. Information from Comprehensive Geriatric Assessments (CGA), treatment decisions, and 3- and 6-month clinical outcomes will be collected to evaluate and validate the decision-support platform's performance in assisting oncology teams.

Study Overview

Status

Not yet recruiting

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

Observational

Enrollment (Estimated)

412

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • São Paulo
      • São Paulo, São Paulo, Brazil, 05653-000
        • HIAE - Hospital Israelita Albert Einstein
        • Principal Investigator:
          • Ludmila de Oliveira Muniz Koch
      • São Paulo, São Paulo, Brazil, 04004-060
        • BR192 HCOR - Hospital do Coração
        • Principal Investigator:
          • Luciola Pontes Leite de Barros

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consists of older adults (aged 65 years and older) diagnosed with solid tumor cancers who receive care in public and private health institutions in South America (Chile, Brazil, and Peru). The retrospective cohort includes anonymized historical data from patients evaluated by the Oncogeriatric Tele-Committee of the Chilean Ministry of Health. The prospective cohort comprises consecutive patients seen in routine oncological care who undergo a Comprehensive Geriatric Assessment (CGA) and are managed by local oncogeriatric teams.

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

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
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.
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Predictive Accuracy of the PROTEGER Machine Learning Model
Time Frame: Up to 6 months post-enrollment.
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).
Up to 6 months post-enrollment.

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.
Percentage of participants experiencing Grade 3 or higher toxicities/adverse reactions evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
At 3 and 6 months post-enrollment.
General Quality of Life Score (EORTC QLQ-C30)
Time Frame: Baseline, 3 months, and 6 months post-enrollment.
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.
Baseline, 3 months, and 6 months post-enrollment.
Elderly-Specific Quality of Life Score (EORTC QLQ-ELD14)
Time Frame: Baseline, 3 months, and 6 months post-enrollment.
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.
Baseline, 3 months, and 6 months post-enrollment.
Incidence of Hospitalizations
Time Frame: At 3 and 6 months post-enrollment.
Number of patients requiring unplanned hospital admissions during the treatment course
At 3 and 6 months post-enrollment.
Treatment Discontinuation and Dose Reduction Rates
Time Frame: At 3 and 6 months post-enrollment.
Percentage of patients undergoing chemotherapy dose reductions (planned vs. received dose) or early treatment discontinuation.
At 3 and 6 months post-enrollment.
Patient Survival and Disease Progression
Time Frame: At 3 and 6 months post-enrollment.
Overall survival status and disease progression rate assessed according to RECIST 1.0 criteria.
At 3 and 6 months post-enrollment.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Luciola Pontes Leite de Barros, Hospital do Coração (HCOR)

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

July 1, 2027

Study Registration Dates

First Submitted

August 24, 2026

First Submitted That Met QC Criteria

September 1, 2026

First Posted (Actual)

September 4, 2026

Study Record Updates

Last Update Posted (Actual)

September 4, 2026

Last Update Submitted That Met QC Criteria

September 1, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • LACOG 0325

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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