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Myelodysplastic Syndromes
Geriatric Oncology

Transplant May Improve Survival in Older Patients With High-Risk Myelodysplastic Syndrome

Stem cell transplants are not frequently offered to older patients with high-risk myelodysplastic syndromes (MDS). According to a study from the Blood and Marrow Transplant Clinical Trials Network (BMTCTN 1102), these patients may indeed achieve a survival benefit from stem cell transplant. As...

Lymphoma
Geriatric Oncology

Lenalidomide Plus Subcutaneous Rituximab-MiniCHOP in Patients Aged 80 or Older With DLBCL

In the French phase III SENIOR trial reported in the Journal of Clinical Oncology, Oberic et al found that the addition of lenalidomide to subcutaneous rituximab plus attenuated-dose CHOP (mini-CHOP; cyclophosphamide, doxorubicin, vincristine, prednisone) did not improve overall survival in...

Breast Cancer
Geriatric Oncology

New Surveillance Mammography Screening Guidelines Issued for Breast Cancer Survivors Aged 75 and Older

A nationwide panel of experts has developed the first mammography guidelines for older survivors of breast cancer, providing a framework for discussions between survivors and their physicians on screening in survivors’ later years. The guidelines, published today by Rachel A. Freedman, MD, MPH, and ...

Breast Cancer
Geriatric Oncology
Symptom Management

Novel Risk Tool for Predicting Severe Toxicity in Older Patients Receiving Chemotherapy for Early-Stage Breast Cancer

As reported in the Journal of Clinical Oncology, Allison Magnuson, DO, and colleagues have developed a risk tool for predicting severe toxicity in patients aged 65 and older receiving chemotherapy for early-stage breast cancer. Study Details The prospective cohort study included 473 patients...

Breast Cancer
Geriatric Oncology

Addition of Chemotherapy to Local Therapy in Women Aged 70 or Older With Triple-Negative Breast Cancer

In a National Cancer Database analysis reported in The Lancet Oncology, Crozier et al found that receipt of neoadjuvant or adjuvant chemotherapy was associated with improved overall survival among women aged 70 or older undergoing surgery for stage I to III triple-negative breast cancer. Study...

Geriatric Oncology

Geriatric Assessment: Vital Element in Individualizing Care for Older Patients With Cancer

Caring for older adults with cancer is the purview of every oncologist. Over the next 30 years, the older adult population (65 years and older) will represent the fastest-growing segment of the world population. Globally, the number of persons 80 years and older is expected to triple from 143...

Geriatric Oncology
COVID-19

The COVID-19 Pandemic and Cancer Care for Older Patients in the United States: Effect on Diagnosis and Treatment

In a study of data from a Medicare fee-for-service population reported in JCO Clinical Cancer Informatics, Debra Patt, MD, PhD, MBA, and colleagues found that the COVID-19 pandemic has resulted in a “substantial decrease in cancer screenings, visits, therapy, and surgeries among older patients with ...

Geriatric Oncology
Cost of Care

Self-Reported Financial Distress Among Older Adults With Cancer Prior to Initiating Therapy

In a single-institution study reported in JCO Oncology Practice, Smith Giri, MD, MHS, and colleagues found that 27% of patients with cancer aged 60 or older reported financial distress in response to a query prior to starting systemic therapy. Numerous demographic and geriatric assessment...

Geriatric Oncology

As a Young Oncologist, Enrique Soto Pérez de Celis, MD, MSc, Met a Career-Changing Mentor at the ASCO Annual Meeting

Geriatric oncologist and researcher Enrique Soto Pérez de Celis, MD, MSc, was born in Mexico City and grew up in the nearby city of Puebla. “There were no physicians in the family who might have influenced my decision to become a doctor, but both of my parents were academics; my mother was a...

Breast Cancer
Geriatric Oncology

Surgery Improves Survival in Older Women With Early Estrogen Receptor–Positive Breast Cancer

Older women with estrogen receptor–positive breast cancer have poorer survival than younger women, but this gap might be closed by offering surgery to women over age 70 who are fit and have resectable tumors. According to a study presented at the 12th European Breast Cancer Conference (EBCC 12),...

Geriatric Oncology
Symptom Management

Expert Point of View: Monika K. Krzyzanowska, MD

Formal discussant of the abstract, Monika K. Krzyzanowska, MD, a medical oncologist at Princess Margaret Cancer Centre and Professor of Medicine at the University of Toronto, said this study extends the evidence base on geriatric assessment in oncology and shows that geriatric assessment should be...

Symptom Management
Geriatric Oncology

Reducing Symptomatic Toxicity Burden in Older Patients With Advanced Cancer Via Geriatric Assessment

As the number of older patients with cancer continues to rise, interventions that reduce the high rates of symptoms, toxicity, and distress in this population are urgently needed. Research presented during the 2020 ASCO Quality Care Symposium has added to the growing body of evidence supporting...

Geriatric Oncology

Time at Home vs in Health-Care Institutions for Older Patients After Cancer Surgery

In a Canadian population-based cohort study reported in JAMA Surgery, Chesney et al found that older patients undergoing surgery for cancer were likely to spend a high number of days at home vs in health-care institutions in the years following surgery for cancer, suggesting favorable functional...

Geriatric Oncology

Surgical and Radiation Oncology in Elderly Patients With Cancer

As one might expect, the focus on older patients developed in surgical and radiation oncology at the same time as in medical oncology. As we have done in our overview of medical oncology, we may recognize a prehistory, past history, and present history in surgical and radiation geriatric oncology....

Geriatric Oncology

Cancer in Older Adults: The History of Geriatric Oncology, Part 2: 1990–2020

In part 1 of this three-part article, which was published in the October 10, 2020, issue of The ASCO Post, we chronicled the progress made in geriatric oncology up to the decade of the 1990s, which saw an explosion of research activity in the study of aging and cancer. In part 2, we review the...

geriatric oncology
symptom management

Marie A. Flannery, PhD, and Eva Culakova, PhD, on Managing Symptoms in Older Adults With Advanced Cancer

Marie A. Flannery, PhD, and Eva Culakova, PhD, both of the University of Rochester, discuss a geriatric assessment tool that helped reduce symptomatic toxicities, as measured by Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (Abstract 138).

Leukemia
Geriatric Oncology

FDA Approves Venetoclax Combination Regimen for Certain Adult Patients With AML

On October 16, the U.S. Food and Drug Administration (FDA) granted regular approval to venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults age 75 or older or who have comorbidities precluding intensive ...

Breast Cancer
Geriatric Oncology

Adjuvant Trastuzumab With or Without Chemotherapy for Older Patients With HER2-Positive Early Breast Cancer

In the Japanese RESPECT trial reported in the Journal of Clinical Oncology, Sawaki et al found that noninferiority of adjuvant trastuzumab alone vs with chemotherapy was not shown for disease-free survival among women with HER2-positive breast cancer between the ages of 70 and 80 years. However, a...

Colorectal Cancer
Geriatric Oncology

Elderly Patients With Advanced Colorectal Cancer Treated With Adjuvant Oxaliplatin Plus Fluoropyrimidines: Tolerability and Benefit

Among patients with stage III colon cancer, patients aged 70 or older were less tolerant of adjuvant oxaliplatin/flouropyrimidine therapy, in addition to having poorer relapse-free interval rates on the regimen, according to findings from a large subgroup analysis of the phase III TOSCA trial...

Geriatric Oncology

Personalized Medicine Meets Geriatric Oncology: Tailoring Oncologic Care for Older Adults

The ASCO20 Virtual Scientific Program was a landmark year for the field of geriatric oncology, featuring more than 300 research abstracts that presented data on older adults with cancer. Here, we discuss several high-impact studies investigating interventions that modify outcomes for this patient...

Geriatric Oncology

Geriatric Comanagement After Cancer Surgery in Patients Aged 75 and Older

In a single-institution study reported in JAMA Network Open, Shahrokni et al found that postoperative care comanaged by the geriatrics service and surgical service was associated with reduced 90-day postoperative mortality vs care managed by the surgical service alone among patients aged 75 and...

Issues in Oncology
Geriatric Oncology

Aspirin May Accelerate the Progression of Advanced Cancers in Older Adults

Results from a recent clinical trial indicated that for older adults with advanced cancer, initiating aspirin treatment may increase their risk of disease progression and mortality. These findings were published by McNeil et al in the Journal of the National Cancer Institute. Study Background and...

Leukemia
Geriatric Oncology

ASH Releases New Clinical Practice Guidelines on the Treatment of Older Adults With Newly Diagnosed Acute Myeloid Leukemia

The American Society of Hematology (ASH) has published new guidelines to help older adults with acute myeloid leukemia (AML) and their health-care providers make critical care decisions, including if and how to proceed with cancer treatment and the need for blood transfusions for those in hospice...

leukemia
geriatric oncology

Andrew H. Wei, MBBS, PhD, on AML: Venetoclax Plus Cytarabine in Older Patients

Andrew H. Wei, MBBS, PhD, of The Alfred Hospital, Monash University, discusses phase III data from the VIALE-C trial, which appear to support the use of venetoclax plus low-dose cytarabine as a front-line treatment for older patients with acute myeloid leukemia, as well as for those who cannot tolerate intensive chemotherapy (Abstract S136).

Leukemia
Geriatric Oncology

Expert Point of View: Alice Mims, MD

Alice Mims, MD, Associate Professor of Hematology at The Ohio State University Comprehensive Cancer Center–The James, shared her insights on the VIALE-A study. “The results of the VIALE-A study have been highly anticipated and are exciting, given the improvement seen in both overall survival and...

Leukemia
Geriatric Oncology

VIALE-A Trial Supports Survival Benefit of Venetoclax Plus Azacitidine in Elderly Patients With AML

In the phase III VIALE-A trial, venetoclax added to azacitidine led to a significant and clinically meaningful improvement in response rates and overall survival, as compared with azacitidine alone, in treatment-naive predominantly elderly patients with acute myeloid leukemia (AML) ineligible for...

Geriatric Oncology

The Importance of Measuring Health-Related Quality of Life in Older Adults

Compared with younger patients, older patients with cancer face unique challenges because many of them have age-related decreases in health-related quality of life. This can be a result of many factors, such as comorbidities, mental health, physical impairment, and financial stressors. A diagnosis...

Geriatric Oncology

Geriatric Assessment: What Are You Waiting For?

The ASCO20 Virtual Scientific Program was the forum for an unusual but profoundly important event in oncology. Four studies that should be practice-changing were presented.1-4 These studies provided irrefutable evidence that we can improve the quality of life of older patients by reducing toxicity. ...

Geriatric Oncology

Geriatric Assessment–Driven Intervention Benefits Older Adults With Cancer

Geriatric assessment–driven interventions—such as physical therapy, nutritional recommendations, and social support, among others—can reduce toxicity due to chemotherapy in adults with cancer aged 65 years and older, according to results from a randomized clinical trial presented as part of ASCO20...

Geriatric Oncology

Expert Point of View: William Dale, MD, PhD

"We have known for a long time, based on good evidence, that geriatric assessment is good at accurately identifying patients at high risk for chemotherapy-induced toxicity, surgical complications, and increased hospitalizations. This study adds an intervention component based on the geriatric...

Geriatric Oncology

Geriatrician Assessment and Integrated Care May Help Older Patients as Well as the Health-Care System

A full geriatric assessment and geriatrician-led multidisciplinary care improved the quality of life of patients aged 70 and older undergoing chemotherapy, targeted therapy, or immunotherapy, according to results of a prospective, randomized, controlled, open-label trial, reported in a press...

Issues in Oncology
Geriatric Oncology

Polypharmacy and Inpatient Hospitalization Rates in Older Patients With Cancer

In a study published by Grace Lu-Yao, PhD, and colleagues in the Journal of Geriatric Oncology, researchers found hospitalization rates can increase by as much as 114% in patients with breast, prostate, and lung cancers when those patients have taken 15 or more medications prior to chemotherapy...

Geriatric Oncology

Cancer in the Aging Population: ‘Leaving No One Behind’

With the motto of “leaving no one behind,” 420 delegates from 40 countries and 61 faculty members from 19 countries attended the Annual Meeting of the International Society of Geriatric Oncology (SIOG) in Geneva on November 14–16, 2019. SIOG serves as a platform to discuss a myriad of aspects...

Geriatric Oncology

Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting

Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form the majority ...

Lymphoma
Immunotherapy
Geriatric Oncology
Cost of Care

Expert Point of View: Michael Jain, MD, PhD

Michael Jain, MD, PhD, Assistant Member in the Department of Blood and Marrow Transplant and Cellular Immunotherapy at Moffitt Cancer Center, Tampa, Florida, commented on Dr. Kilgore’s findings. Dr. Jain was coauthor of a study by the U.S. Lymphoma CAR T Consortium that presented real-world data...

Lymphoma
Immunotherapy
Geriatric Oncology
Cost of Care

Real-World Data for CAR T-Cell Therapy Show Benefit in Older Patients With Lymphoma, Lower Subsequent Health-Care Costs

Once considered highly experimental, chimeric antigen receptor (CAR) T-cell therapy is now an established third-line treatment option for B-cell lymphomas and leukemias. CAR T-cell therapy has saved the lives of people who would otherwise have run out of treatment options. But the question is...

Geriatric Oncology

How Real-World Data Can Help Contextualize New Treatments in Older Patients

Consider a patient who is referred for neoadjuvant therapy for stage IIIA, HER2-positive breast cancer. She is otherwise healthy, with no significant medical history, an Eastern Cooperative Oncology Group performance status of 0, unremarkable baseline labs, and a left-ventricular ejection fraction...

Leukemia
Geriatric Oncology

Oral CC-486 Maintenance Therapy Extends Survival in Older Patients With AML

Use of CC-486—an investigational oral form of azacitidine—as maintenance therapy significantly improved overall survival and relapse-free survival in older patients with newly diagnosed acute myeloid leukemia (AML) who were in remission following induction chemotherapy with or without consolidation ...

Immunotherapy
Lymphoma
Geriatric Oncology

ASH 2019: CAR T-Cell Therapy Shows Activity, Reduces Health-Care Utilization in Older Patients With DLBCL

A new analysis of Medicare claims data presented by  Kilgore et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 793) has provided the first real-world evidence using claims data available after the approval of autologous anti-CD19 chimeric antigen...

Multiple Myeloma
Geriatric Oncology

ASH 2019: Is Autologous Hematopoietic Stem Cell Transplant Safe and Effective for Patients Aged 70 or Older With Multiple Myeloma?

Even though autologous hematopoietic stem cell transplantation (AHCT) is an effective treatment for multiple myeloma, only 4 out of 10 patients receive this therapy. A new study presented by Munshi et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 782) ...

Multiple Myeloma
Geriatric Oncology

Use of an On-Site Touchscreen-Based Geriatric Assessment for Older Patients With Multiple Myeloma

In a study reported in the Journal of Oncology Practice, Nathwani et al found that the use of a tablet-based modified geriatric assessment during physician visits by older patients with multiple myeloma was feasible and provided physicians with information that influenced treatment decisions. Study ...

Hematologic Malignancies
Geriatric Oncology

Geriatric Assessment–Guided Multidisciplinary Care May Benefit Older Patients Undergoing Stem Cell Transplantation

Older adults with blood cancers may benefit from a team-based, holistic evaluation before undergoing transplantation, according to a study published by Derman et al in Blood Advances. The study, which reported on a multidisciplinary clinic at the University of Chicago Medical Center, found that...

Geriatric Oncology

Improving Communication With Older Patients Using Geriatric Assessment During Oncology Visits

In the COACH study, reported in JAMA Oncology, Supriya G. Mohile, MD, MS, and colleagues found that including geriatric assessment in oncology visits for older adults with advanced cancer improved patient and caregiver satisfaction with communication regarding aging-related concerns. Study Details...

Colorectal Cancer
Geriatric Oncology

Short-Term Survival in Patients Aged 85 Years and Older After Colorectal Cancer Surgery

Results from a preliminary research study showed the majority of patients aged 85 years and older were still alive in the short-term after undergoing segmental colectomy for stage II and III colon cancer. Kaur et al presented these findings at the American College of Surgeons Clinical Congress...

Breast Cancer
Geriatric Oncology

Pooled Analysis of Outcomes in Older Women With Metastatic Breast Cancer Receiving CDK4/6 Inhibitor Plus Aromatase Inhibitor Therapy

In a U.S. Food and Drug Administration (FDA) pooled analysis reported in the Journal of Clinical Oncology, Howie et al found that progression-free survival and benefit were similar for older vs younger postmenopausal women treated with combined cyclin-dependent kinase 4/6 (CDK4/6) plus aromatase...

Issues in Oncology
Geriatric Oncology

Older Sexual and Gender Minorities With Cancer: A Population Hidden in the Open

The term “sexual and gender minorities” encompasses people whose sexual orientation, gender identity and expression, or reproductive development varies from traditional, societal, cultural, or physiologic norms1 and includes lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. More than 3 ...

Head and Neck Cancer
Geriatric Oncology

ESMO 2019: Personalized Treatment for Head and Neck Cancer Based on Geriatric Assessment

Fit elderly patients aged 70 years and older with head and neck squamous cell carcinoma were able to undergo rigorous treatment that provided benefit similar to that observed in younger patients. However, elderly patients with head and neck squamous cell carcinoma classified by geriatric assessment ...

Issues in Oncology
Geriatric Oncology

HIV-Positive Older Adults With Cancer and Worsened Disease Outcomes

In a study reported in JAMA Oncology, Anna E. Coghill, PhD, MPH, and colleagues found that outcomes are often worse among human immunodeficiency virus (HIV)-positive patients aged 65 years or older with cancer vs HIV-negative patients with cancer, after adjustment for first courses of treatment....

Issues in Oncology
Geriatric Oncology

Polypharmacy Associated With Functional Decline in Older Patients With Advanced Cancer

Polypharmacy (ie, the concurrent use of eight or more medications) and potentially inappropriate medications may be associated with functional impairment in older adults with advanced cancer, according to research presented by ­Mostafa Mohamed, MBBCh, at the Multinational Association of Supportive...

Issues in Oncology
Geriatric Oncology

All Oncologists Are Geriatric Oncologists...They Just Don’t Know It Yet

You don’t have to be a geriatrician to properly evaluate and manage older patients with cancer. The wave of older patients with cancer predicted over 30 years ago is now fully upon us. The oncology community finds itself ill-prepared to manage the increased number of older patients. It is not just...

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