The Evolution of Geriatric Oncology and Geriatric Assessment over the Past Decade

Outlaw, Darryl; Abdallah, Maya; Gil-Jr, Luiz A.; Giri, Smith; Hsu, Tina; Krok‐Schoen, Jessica L.; Liposits, Gábor; Madureira, Tânia; Marinho, Joana; Subbiah, Ishwaria Mohan; Tuch, Gina; Williams, Grant R.

doi:10.1016/j.semradonc.2021.11.002

Cited by 14 publications

(6 citation statements)

References 77 publications

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“…Table 2 shows patient characteristics obtained by the GA-patient tool. The mean score of Instrumental Activities of Daily Living was 12.1 (range, [8][9][10][11][12][13][14]. The mean score of comorbidity scale was 6.5 (range, 1-12).…”

Section: Geriatric Assessment-patient Toolmentioning

confidence: 99%

Concurrent nimotuzumab and intensity‐modulated radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma

Cao,

Fang,

Jiang

et al. 2024

Cancer Science

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Because of the common physical condition, reduced organ function, and comorbidities, elderly patients with nasopharyngeal carcinoma (NPC) are often underrepresented in clinical trials. The optimal treatment of elderly patients with locally advanced NPC remains unclear. The purpose of this study was to evaluate the efficacy of concurrent nimotuzumab combined with intensity‐modulated radiotherapy (IMRT) in elderly patients with locally advanced NPC. We conducted a single‐arm, phase II trial for elderly patients with stage III–IVA NPC (according to UICC–American Joint Committee on Cancer TNM classification, 8th edition). All patients received concurrent nimotuzumab (200 mg/week, 1 week prior to IMRT) combined with IMRT. The primary end‐point was complete response (CR) rate. The secondary end‐points were survival, safety, and geriatric assessment. Between March 13, 2017 and November 12, 2018, 30 patients were enrolled. In total, 20 (66.7%) patients achieved CR, and objective response was observed in 30 (100.0%) patients 1 month after radiotherapy. The median follow‐up time was 56.05 months (25th–75th percentile, 53.45–64.56 months). The 5‐year locoregional relapse‐free survival, distant metastasis‐free survival, cancer‐specific survival, disease‐free survival, and overall survival were 89.4%, 86.4%, 85.9%, 76.5%, and 78.8%, respectively. Grade 3 mucositis occurred in 10 (33%) patients and grade 3 pneumonia in 3 (10%) patients. Concurrent nimotuzumab combined with IMRT is effective and well‐tolerated for elderly patients with locally advanced NPC.

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Section: Geriatric Assessment-patient Toolmentioning

confidence: 99%

Concurrent nimotuzumab and intensity‐modulated radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma

Cao,

Fang,

Jiang

et al. 2024

Cancer Science

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“…Malignancies occur at any age, but the incidence of cancer increases with age and is more common in elderly patients. Cancer is the leading cause of death among men and women aged 60-79 years; 60% of newly diagnosed cancers are seen in patients aged 65 and over, and 70% of cancer deaths occur in this age group [1,2]. Due to demographic changes (population aging and increasing life expectancy), the proportion of elderly cancer patients is expected to increase further in the coming decades.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of New Generation Sequencing (NGS)-Based Somatic Gene Variations and Real-Time Polymerase Chain Reaction (PCR)-Based Gene Fusions in Elderly and Young Acute Leukemia Patients: A Retrospective View

Erdoğdu,

Örenay-Boyacıoğlu,

Boyacıoğlu

et al. 2024

JPM

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Malignant diseases occurring in elderly patients follow a different course from younger patients and show different genetic structures. Therefore, in this retrospective study, the somatic gene variant profile and fusion gene profiles of elderly and young acute leukemia patients were determined to draw attention to the existing genetic difference, and the results were compared. In this study, the records of 204 acute leukemia patients aged 18+ who were referred to the Molecular Pathology Laboratory from the Hematology Clinic between 2018 and 2022 were reviewed retrospectively. Fusion gene detection in patients was performed with the HemaVision®-28Q Panel. The NGS Myeloid Neoplasms Panel was conducted using the MiniSEQ NGS platform according to the manufacturer’s protocol. When all cases are evaluated together, the most frequently diagnosed acute leukemia is acute myeloid leukemia (85.8%). Both groups had a similar fusion gene profile; however, the fusion burden was higher in the elderly group. When the groups were evaluated in terms of somatic gene variations, there were differences between the groups, and the variation load was higher in the elderly group. Considering the different somatic gene variation profiles, it is understood that the genetic structure of tumor cells is different in elderly patients compared to young cases.

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“…CGAs provide a means for identifying these needs early so that appropriate intervention and care planning can occur ( Culakova et al, 2023 ; Doi et al, 2023 ; Lin et al, 2023 ; Singhal et al, 2023 ). CGAs are “multidimensional, interdisciplinary diagnostic process[es] focusing on determining an older person’s medical, psychosocial, and functional capabilities to develop a coordinated and integrated plan for treatment and long-term follow-up” ( Ellis et al, 2017 ; Hamaker et al, 2022 ; Outlaw et al, 2022 ). While much work has been done to develop recommendations for CGAs using validated instruments ( Mohile et al, 2018 ; Hamaker et al, 2022 ; Dale et al, 2023 ), research on the actual implementation of CGA processes within primary and specialty care settings for vulnerable populations of aging cancer survivors is lagging.…”

Section: Introductionmentioning

confidence: 99%

Examining provider perceptions and practices for comprehensive geriatric assessment among cancer survivors: a qualitative study with an implementation science focus

Seaman,

Rowland,

Werts

et al. 2023

Front. Aging

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Introduction: Cancer rates increase with age, and older cancer survivors have unique medical care needs, making assessment of health status and identification of appropriate supportive resources key to delivery of optimal cancer care. Comprehensive geriatric assessments (CGAs) help determine an older person’s functional capabilities as cancer care providers plan treatment and follow-up care. Despite its proven utility, research on implementation of CGA is lacking.Methods: Guided by a qualitative description approach and through interviews with primary care providers and oncologists, our goal was to better understand barriers and facilitators of CGA use and identify training and support needs for implementation. Participants were identified through Cancer Prevention and Control Research Network partner listservs and a national cancer and aging organization. Potential interviewees, contacted via email, were provided with a description of the study purpose. Eight semi-structured interviews were conducted via Zoom, recorded, and transcribed verbatim by a professional transcription service. The interview guide explored providers’ knowledge and use of CGAs. For codebook development, three representative transcripts were independently reviewed and coded by four team members. The interpretive process involved reflecting, transcribing, coding, and searching for and identifying themes.Results: Providers shared that, while it would be ideal to administer CGAs with all new patients, they were not always able to do this. Instead, they used brief screening tools or portions of CGAs, or both. There was variability in how CGA domains were assessed; however, all considered CGAs useful and they communicated with patients about their benefits. Identified facilitators of implementation included having clinic champions, an interdisciplinary care team to assist with implementation and referrals for intervention, and institutional resources and buy-in. Barriers noted included limited staff capacity and competing demands on time, provider inexperience, and misaligned institutional priorities.Discussion: Findings can guide solutions for improving the broader and more systematic use of CGAs in the care of older cancer patients. Uptake of processes like CGA to better identify those at risk of poor outcomes and intervening early to modify treatments are critical to maximize the health of the growing population of older cancer survivors living through and beyond their disease.

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The Evolution of Geriatric Oncology and Geriatric Assessment over the Past Decade

Cited by 14 publications

References 77 publications

Concurrent nimotuzumab and intensity‐modulated radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma

Concurrent nimotuzumab and intensity‐modulated radiotherapy for elderly patients with locally advanced nasopharyngeal carcinoma

Evaluation of New Generation Sequencing (NGS)-Based Somatic Gene Variations and Real-Time Polymerase Chain Reaction (PCR)-Based Gene Fusions in Elderly and Young Acute Leukemia Patients: A Retrospective View

Examining provider perceptions and practices for comprehensive geriatric assessment among cancer survivors: a qualitative study with an implementation science focus

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