Value of combining biological age with assessment of individual frailty to optimize management of cancer treated with targeted therapies: model of chronic myeloid leukemia treated with tyrosine kinase inhibitors (BIO-TIMER trial)

• Published in: BMC cancer 2024-05, Vol.24 (1), p.661-8, Article 661
• Main Authors: Casile, Mélanie, Albrand, Gilles, Lebecque, Benjamin, Besombes, Joévin, Bourgne, Céline, Pereira, Bruno, Saugues, Sandrine, Jamot, Caroline, Hermet, Eric, Berger, Marc G
• Format: Article
• Language: English
• Subjects: Adult; Age; Age determination; Aged; Aged, 80 and over; Aging; Biological Age; Biomarkers; Bone marrow; Cancer therapies; Chronic myeloid leukemia; Decision making; Demographic aspects; Diagnosis; Disease management; DNA Methylation; Drug dosages; Drug therapy; Female; Frailty; Health aspects; Humans; Individual Frailty; Influence; ISO standards; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy; Longitudinal Studies; Male; Middle Aged; Minimal residual disease; Molecular Targeted Therapy; Mortality; Myeloid leukemia; Observatories; Patients; Precision medicine; Precision Medicine - methods; Prospective Studies; Protein Kinase Inhibitors - therapeutic use; Quality of Life; Standardization; Tyrosine Kinase Inhibitors
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-12415-2

In the era of targeted therapies, the influence of aging on cancer management varies from one patient to another. Assessing individual frailty using geriatric tools has its limitations, and is not appropriate for all patients especially the youngest one. Thus, assessing the complementary value of a potential biomarker of individual aging is a promising field of investigation. The chronic myeloid leukemia model allows us to address this question with obvious advantages: longest experience in the use of tyrosine kinase inhibitors, standardization of therapeutic management and response with minimal residual disease and no effect on age-related diseases. Therefore, the aim of the BIO-TIMER study is to assess the biological age of chronic myeloid leukemia or non-malignant cells in patients treated with tyrosine kinase inhibitors and to determine its relevance, in association or not with individual frailty to optimize the personalised management of each patient. The BIO-TIMER study is a multi-center, prospective, longitudinal study aiming to evaluate the value of combining biological age determination by DNA methylation profile with individual frailty assessment to personalize the management of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors. Blood samples will be collected at diagnosis, 3 months and 12 months after treatment initiation. Individual frailty and quality of life will be assess at diagnosis, 6 months after treatment initiation, and then annually for 3 years. Tolerance to tyrosine kinase inhibitors will also be assessed during the 3-year follow-up. The study plans to recruit 321 patients and recruitment started in November 2023. The assessment of individual frailty should make it possible to personalize the treatment and care of patients. The BIO-TIMER study will provide new data on the role of aging in the management of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors, which could influence clinical decision-making. ClinicalTrials.gov , ID NCT06130787; registered on November 14, 2023.