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Geriatric Oncology
Issues in Oncology

Modified Chemotherapy Regimens May Improve Quality of Life in Older Patients With Advanced Cancer

Reducing doses and adjusting chemotherapy schedules in older patients with advanced cancer may help improve treatment tolerability without compromising its efficacy, according to a recent study published by Mohamed et al in JAMA Network Open. Background Standard chemotherapy regimens—mostly based...

Geriatric Oncology
Issues in Oncology

New Poll Weighs Necessity of Life Expectancy in Cancer Screening Guidelines

A majority of older adults may disagree with the idea of using life expectancy as part of cancer screening guidelines, according to a new University of Michigan National Poll on Healthy Aging. Background The response goes against a trend in guidelines aimed at helping health-care providers decide...

Geriatric Oncology

ASCO Updates Guideline on Assessment, Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy

ASCO has updated a guideline on the practical assessment and management of age-associated vulnerabilities in older patients receiving systemic cancer therapy.1 Among the updates, the guideline adds more detail to domains that should be evaluated in geriatric assessments (GAs) and expands patient...

Breast Cancer
Geriatric Oncology

Breast Cancer Overdiagnosis May Be Common Among Older Female Patients

Continued breast cancer screening after age 70 may be associated with a greater incidence of asymptomatic cancer, according to a recent study published by Richman et al in the Annals of Internal Medicine. These new findings suggested that overdiagnosis may be prevalent among older female patients....

Prostate Cancer
Geriatric Oncology

PSMA PET/CT Imaging May Eliminate the Need for Preimaging Biopsy in Older Patients Undergoing Screening for Prostate Cancer

Prostate-specific membrane antigen positron-emission tomography/computed tomography (PSMA PET/CT) imaging may help physicians diagnose advanced disease and select the appropriate therapeutic interventions in patients aged 80 years or older with suspected prostate cancer, according to a recent study ...

Colorectal Cancer
Survivorship
Geriatric Oncology

Gastrointestinal Symptoms May Be Prevalent in Geriatric Female Colorectal Cancer Survivors

About 80% of geriatric female colorectal cancer survivors may experience a range of gastrointestinal symptoms years after receiving a diagnosis and treatment for their tumors, according to a recent study published by Han et al in PLOS ONE. Background While depression, anxiety, and fatigue are...

Leukemia
Geriatric Oncology

CLL14: Long-Term Results of Fixed-Duration Venetoclax Plus Obinutuzumab in Elderly Patients With CLL

The 6-year follow-up of a landmark study has revealed significant treatment-free remissions and safety findings in elderly patients with chronic lymphocytic leukemia (CLL) and coexisting medical conditions.1 Long-term results of the CLL14 trial, presented during the European Hematology Association...

Colorectal Cancer
Geriatric Oncology

Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery

In a study of real-world prospective data—GOSAFE—reported in the Journal of Clinical Oncology, Montroni et al found that the majority of patients aged ≥ 70 years undergoing colorectal cancer surgery showed maintained or improved quality of life and achieved functional recovery during follow-up....

Geriatric Oncology
Global Cancer Care

Assessing Geriatric Oncology Practice in Portugal

The global population is aging rapidly. Currently, there are more than 703 million people worldwide aged 65 and older, representing 9.1% of the global population. It is estimated that this percentage will grow to 15.9%—1.5 billion people—by 2050.1 And with that growing aging population will come...

Breast Cancer
Survivorship
Geriatric Oncology

Older Breast Cancer Survivors May Experience Accelerated Aging, Worse Functional Outcomes Following Chemotherapy

Investigators have found that older breast cancer survivors—particularly those exposed to chemotherapy—may experience greater epigenetic aging and poorer outcomes than those without a history of cancer, according to a new study published by Rentscher et al in Cancer. Background Epigenetic aging...

Breast Cancer
Geriatric Oncology

Does Surveillance Mammography Benefit Geriatric Patients With Breast Cancer?

Investigators have found that undergoing an annual surveillance mammography may remain common among geriatric patients with breast cancer, even in those with only a small risk of developing a second primary tumor or with significant competing mortality risks as a result of advanced age and...

Genomics/Genetics
Geriatric Oncology

Cancer Susceptibility Germline Pathogenic Variants Among Older Patients

Hereditary cancer syndromes are caused by a pathogenic variant in cancer susceptibility genes, which overall account for approximately 10% of all cancers. Carriers of pathogenic variants are at an increased risk of developing cancer during their lifetime. Genomic cancer risk assessment makes it...

Breast Cancer
Geriatric Oncology

Change in Frailty Status Among Older Patients Undergoing Locoregional Therapy for Early-Stage Breast Cancer

In a cohort study reported in a research letter in JAMA Surgery, Minami et al found that frailty status worsened in a sizable proportion of older patients receiving locoregional therapy—including lumpectomy or mastectomy—for early-stage breast cancer. Baseline robust status and mastectomy were...

Geriatric Oncology

Highlights of the 2022 Annual Conference of the International Society of Geriatric Oncology

The 2022 Annual Conference of the International Society of Geriatric Oncology (SIOG) was held in Geneva, Switzerland, on October 28–30, 2022. The meeting was held in conjunction with the SIOG 2022 Public Policy Meeting: Global Policy to Action on Cancer in the Aging Population at UN Headquarters...

Immunotherapy
Geriatric Oncology

Antibiotic Exposure Before Immune Checkpoint Inhibitor Treatment and Overall Survival in Older Patients With Cancer

In a study reported in the Journal of Clinical Oncology, Eng et al found that exposure to antibiotics within 1 year of starting immune checkpoint inhibitor therapy was associated with poorer survival among patients with cancer who were aged 65 years and older. Study Details The population-based...

Geriatric Oncology
Pain Management

Older Minority Patients With Cancer Face Inequities in Opioid Access Near the End of Life

Research shows that pain is a common byproduct of cancer and its treatment, with approximately 55% of patients undergoing active treatment experiencing pain, and more than 66% of patients with advanced disease experiencing pain. According to the ASCO guideline on the use of opioids for adults with...

Breast Cancer
Geriatric Oncology

Chemotherapy Dose Intensity and Survival in Older Women With Early-Stage Breast Cancer: Analysis From the HOPE Trial

In an analysis from the HOPE trial reported in the Journal of Clinical Oncology, Mina S. Sedrak, MD, MS, and colleagues found that approximately one-fifth of older women with early-stage breast cancer received a relative dose intensity (RDI) of neoadjuvant/adjuvant chemotherapy that was below...

Geriatric Oncology

Impact of Geriatric Assessment and Management on Quality of Life and Other Outcomes in Older Patients With Cancer

In the Canadian 5C study reported in the Journal of Clinical Oncology, Puts et al found that a geriatric assessment and management intervention did not improve quality of life, unplanned health-care use, mortality, or toxicity compared with usual care in patients aged 70 years or older with cancer. ...

Geriatric Oncology
Symptom Management

Effect of Geriatric Assessment Intervention on Patient-Reported Symptomatic Toxicity in Patients Aged 70 and Older Receiving Treatment for Advanced Cancer

In a secondary analysis of the Geriatric Assessment for Patients 70 Years and Older (GAP70+) trial reported in the Journal of Clinical Oncology, Eva Culakova, PhD, MS, and colleagues found that providing geriatric assessment–based recommendations to community oncologists was associated with reduced ...

Colorectal Cancer
Geriatric Oncology

Treatments and Outcomes for Locally Advanced Rectal Cancer in Patients Aged 80 and Older

In an analysis of National Cancer Database data reported in JAMA Surgery, Nassoiy et al found that neoadjuvant chemoradiation therapy followed by surgery was associated with higher rates of R0 resection and improved survival vs other treatments in patients aged 80 and older undergoing surgery for...

Breast Cancer
Geriatric Oncology

Inflammatory Markers and Clinical Decline After Adjuvant Chemotherapy in Older Women With Breast Cancer

As reported in the Journal of Clinical Oncology by Ji et al, the HOPE study (Hurria Older Patients [HOPE] with Breast Cancer Study) has shown that older women categorized as robust prior to adjuvant chemotherapy are at risk for clinical decline postchemotherapy, with high baseline levels of the...

Global Cancer Care
Geriatric Oncology

Geriatric Oncology and Hematology in Singapore

Globally, the population is aging, with the number of people aged 60 and older projected to double from 1 billion worldwide in 2020 to 2.1 billion by 2050. Given the aging population, coupled with the risk of cancer increasing with age, an exponential rise in cases of older adults diagnosed with...

Hematologic Malignancies
Geriatric Oncology

Relationship Between Polypharmacy and Frailty Among Older Adults With Blood Cancers

A new study published by Hshieh et al in JNCCN–Journal of the National Comprehensive Cancer Network suggests a new way for hematologic oncologists to protect older patients from the risks of medication interactions. As part of the Older Adult Hematologic Malignancies Program, gerontology...

Geriatric Oncology
Cardio-oncology

Geriatrics Experts Explore Relationship Between Heart Disease and Cancer

Experts’ discussions and recommendations addressing the interface between cancer and heart disease were published by Supriya Mohile, MD, MS, and colleagues in the Journal of the American Geriatrics Society, summarizing sessions from a virtual bench-to-bedside conference hosted by the American...

Hematologic Malignancies
Geriatric Oncology

Are Virtual Frailty Assessments for Older Patients With Hematologic Malignancies Effective?

According to a study published by DuMontier et al in the journal Blood Advances, frailty assessments—geriatric exams considered essential to predicting health outcomes in older adults with cancer—are both safe and feasible when conducted virtually for patients with blood cancers. While providers...

Geriatric Oncology

Missed Opportunities in Geriatric Oncology Research

The underrepresentation of older patients (≥ 65 years) in clinical trials has been well documented for more than 20 years. This has been an issue at all phases of drug development, including pivotal trials for drug approvals,1 despite the fact that many of these new therapeutics will primarily be...

Geriatric Oncology

Oncologists’ Use of Geriatric Assessment Instruments in Older Patients With Cancer

In a study of a population of predominantly community-based oncologists reported in JCO Oncology Practice, Ajeet Gajra, MD, and colleagues found that a majority of oncologists surveyed did not use a formal geriatric assessment instrument to assist in treatment decisions for older patients with...

Geriatric Oncology

SIOG Annual Conference Explores the Past, Present, and Future of Geriatric Oncology

The 2021 Annual Conference of the International Society of Geriatric Oncology (SIOG) was held on November 4–5. Although participants could not join the conference in person, attendees could still stay informed about the latest developments in geriatric oncology through the virtual platform. The...

Pancreatic Cancer
Geriatric Oncology

Use of Adjuvant Chemotherapy in Older Patients With Pancreatic Cancer and Its Effect on Overall Survival

In a study reported in JAMA Oncology, Mehtsun et al found patterns of increasing use of adjuvant chemotherapy over time among patients aged ≥ 80 years undergoing pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In addition, they found that use of adjuvant chemotherapy was associated...

Geriatric Oncology

Effect of Geriatric Assessment and Management Recommendations on Adverse Events Related to Cancer Treatment

In a U.S. cluster-randomized trial (GAP70+) reported in The Lancet, Supriya G. Mohile, MD, and colleagues found that geriatric assessment and management recommendations reduced the incidence of grade ≥ 3 toxicity vs usual care among patients aged ≥ 70 years with incurable advanced cancers who were...

Geriatric Oncology
Symptom Management

Effect of Geriatric Assessment–Driven Intervention on Incidence of Severe Chemotherapy-Related Toxicity in Older Patients With Cancer

In a single-center study reported in JAMA Oncology, Daneng Li, MD, and colleagues found that a geriatric assessment–driven intervention (GAIN) was associated with a reduced incidence of grade ≥ 3 adverse events and a higher frequency of completion of advance directives vs standard of care among...

Geriatric Oncology

Efficacy of Risk Calculator in Treating Elderly Patients With Cancer

Researchers have shown that using a validated risk calculator helped to drive informed treatment decisions in older patients with cancer. Mbewe et al identified the Cancer and Aging Research Group (CARG) calculator as a quick and helpful tool in assessing chemotherapy toxicity probability in...

Lymphoma
Geriatric Oncology

Older Adults With Primary CNS Lymphoma: Treatment Opportunities and Challenges

The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...

Head and Neck Cancer
Geriatric Oncology

Role of Geriatric Assessment in Personalizing Therapy for Elderly Patients With Head and Neck Cancer

In a prospective evaluation of the role of comprehensive geriatric assessment in personalizing therapy for elderly patients with locally advanced head and neck squamous cell carcinoma (HNSCC), geriatric intervention changed therapeutic choices in about 1 out of 10 patients and played an important...

Immunotherapy
Geriatric Oncology

Biomarker Analysis Evaluates Potential for Immune Checkpoint Blockade Response in Older Patients With Cancer

A retrospective analysis of large data sets of biomarkers from tumors and healthy tissue by researchers at the Johns Hopkins Kimmel Cancer Center Convergence Institute suggests that older patients with cancer may benefit as much from cancer immunotherapies as younger patients. The findings,...

Prostate Cancer
Geriatric Oncology

Second-Generation Androgen Receptor Inhibitors for Older Men With Nonmetastatic Castration-Resistant Prostate Cancer

In a U.S. Food and Drug Administration pooled analysis of clinical trial patient-level data reported in The Lancet Oncology, Fallah et al found that second-generation androgen receptor inhibitor treatment was associated with survival benefits in patients aged 80 years or older with nonmetastatic...

Breast Cancer
Geriatric Oncology
Genomics/Genetics

Risk of Breast Cancer in Women Older Than Age 65 With Germline Pathogenic Variants in Predisposition Genes

In a study reported in the Journal of Clinical Oncology, Boddicker et al found that women older than age 65 in the general population who carry germline pathogenic variants in established high-risk breast cancer predisposition genes remain at significant risk of late-onset breast cancer and should...

Geriatric Oncology

Cancer vs Non–Cancer-Related Deaths Among Older Patients Selected for Surgical Treatment

In a Canadian population-based cohort study reported in JAMA Surgery, Chesney et al found that the 5-year rate of cancer-related deaths exceeded that of non–cancer-related deaths among patients aged 70 or older undergoing surgery for cancer.    Study Details The study used data from ICES (formerly...

Geriatric Oncology

Do Community Oncologists Have Access to Geriatric Specialty Care for Older Patients?

As our population rapidly ages, the burden of cancer incidence increases accordingly, creating an urgent need for greater and more incisive research on the diagnosis, treatment, and survivorship issues for older adults with cancer. Given the numerous challenges faced by today’s busy oncologists, a...

Geriatric Oncology

A Pioneer in Geriatric Oncology Leaves His Mark and Marches Forward

The field of geriatric oncology has developed steadily over the past several decades, thanks to the dedication of a close-knit community of oncologists who have devoted their careers to advancing multidisciplinary care for older patients with cancer. One such leader is Silvio Monfardini, MD, past...

Colorectal Cancer
Geriatric Oncology

Effect of Lower Endoscopy on Colorectal Cancer Incidence and Mortality in Individuals Older Than 75

In a prospective cohort study reported in JAMA Oncology, Ma et al found that lower endoscopy colorectal cancer screening in individuals older than age 75 was associated with reduced colorectal cancer incidence and mortality, although no colorectal cancer mortality benefit was observed in those with ...

Geriatric Oncology

An Epiphany During Fellowship Led to a Career in Geriatric Oncology for Heidi D. Klepin, MD, MS

Geriatric oncologist Heidi D. Klepin, MD, MS, was born and reared in Pearl River, a hamlet on the west side of the Hudson River in New York. “My parents are German immigrants who came to the United States in the 1960s looking for prospects. Growing up in post-war Germany, neither had the...

Gastroesophageal Cancer
Geriatric Oncology

Reduced-Intensity Oxaliplatin/Capecitabine for Older and Frail Patients With Advanced Gastroesophageal Cancer

In the phase III GO2 trial reported in JAMA Oncology, Hall et al found that reduced-intensity oxaliplatin/capecitabine was associated with improved patient experience, reduced toxicity, and noninferior progression-free survival compared with higher-intensity treatment among older and frail patients ...

Geriatric Oncology

Factors Associated With Unplanned Hospitalizations Among Older Patients Receiving Chemotherapy

In a study reported in JCO Oncology Practice, Klepin et al identified several factors associated with unplanned hospitalizations and hospital length of stay among patients with cancer aged 65 and older receiving chemotherapy. Study Details The study was a secondary analysis in a U.S. multisite...

Multiple Myeloma
Geriatric Oncology

Older Patients With Multiple Myeloma May Be Able to Avoid Long-Term Steroid Use

The combination of lenalidomide plus the steroid dexamethasone (together called Rd) is considered standard treatment for elderly patients with multiple myeloma. However, prolonged steroid use can be harmful for some older adults. A new study published by Larocca et al in the journal Blood found...

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...

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