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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

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...

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...

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