EDISCIENCES

ABSTRACT

Abstract Background Immune-checkpoint inhibitors (ICIs) may be offered to patients con- sidered unfit for cytotoxic chemotherapy based on their different toxicity profile despite scarce evidence on efficacy and safety in vulnerable and frail patients with cancer. Objective There is an urgent need to accurately assess patients’ frailty and fitness for ICIs in clinical practice by using an accessible and stre- amlined assessment tool. Methods We reviewed the currently validated frailty scores including the Ea- stern Cooperative Oncology Group (ECOG) performance status, the FRAIL score, the age-adjusted Charlson Comorbidity Index, the Geriatric-8 (G8), the vulnerable elders survey-13 (VES-13) and the Cancer and Aging Research Group (CARG) questionnaires. Results Through a collaboration with ONCOassist (https://oncoassist.com), we developed a free app to support decision-making for oncology clinicians. The tool named the Frailty and Fitness Assessment Tool (F and FT), aims to assess frailty and fitness for ICIs in elderly (ie, > 70 years) and non-elderly patients. Conclusions We advocate a more extensive and objective assessment of patients’ frailty and fitness and frailty by using and validating the F and FT as it represents a clinically practical tool available as a smartphone app to estimate the individual patient’s risk:benefit ratio with ICIs. KEYWORDS Elderly older patients, frailty, fitness, cancer, immunotherapy.