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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...

Geriatric Oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

Issues in Oncology
Prostate Cancer
Geriatric Oncology

Overscreening for Prostate Cancer in Older Men Remains an Issue

Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the...

Leukemia
Geriatric Oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

Leukemia
Geriatric Oncology

Ibrutinib vs Standard of Care in Front-Line Treatment of Older Patients With Chronic Lymphocytic Leukemia

IBRUTINIB (IMBRUVICA) as a front-line agent proved superior to standard-of-care chemoimmunotherapy for chronic lymphocytic leukemia (CLL) in older patients in A041202, an Alliance-led National Clinical Trials Network study.1 At a follow-up of 38 months, the median progression-free survival was not ...

breast cancer
geriatric oncology

Allison Magnuson, DO, on Older Patients With Breast Cancer: A New Tool to Help Guide Treatment Decisions

Allison Magnuson, DO, of the University of Rochester Strong Memorial Hospital, discusses the development of a chemotherapy toxicity risk score that is associated with dose reduction as well as reduced respiratory distress and fewer hospitalizations (Abstract GS6-04).

Geriatric Oncology

Leader in Geriatric Oncology, Arti Hurria, MD, FASCO, Dies at Age 48

ARTI HURRIA, MD, FASCO, died tragically on November 7, 2018, from injuries sustained in a traffic accident. Dr. Hurria was a national leader in geriatric oncology, embracing the age-associated nuances of the elderly, and leading initiatives and research that advanced this specialty field. “The...

geriatric oncology
palliative care

Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care

Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).

geriatric oncology
immunotherapy

Matti S. Aapro, MD, on Immunotherapy in Older Patients

Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the optimal treatment and supportive care for older patients with cancer, including the importance of maintaining dose density and intensity as well as monitoring toxicity.

Geriatric Oncology

Educating Nurse Practitioners on the Care of Older Patients With Cancer in a Comprehensive Cancer Center

To expose future practitioners to the special challenges of treating cancer in older patients, the Geriatrics Service at Memorial Sloan Kettering Cancer Center (MSK) has developed a clinical education model for nurse practitioner students. Why Geriatric Oncology? GIVEN THE aging population, my...

Lymphoma
Geriatric Oncology

Challenges of Managing Older Patients With Diffuse Large B-Cell Lymphoma

As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...

lymphoma
geriatric oncology

Peggy Burhenn, MS, RN-BC, AOCNS, on Lymphoma: Managing Older Adults

Peggy Burhenn, MS, RN-BC, AOCNS, of the City of Hope National Medical Center, discusses the challenges of working with older lymphoma patients and the importance of effective geriatric assessments.

Issues in Oncology
Geriatric Oncology

Expert Point of View: Joshua A. Jones, MD, MA

“AS A SOCIETY, we often think about the value of cancer treatments in terms of survival, but for older patients, we need to look beyond that. Geriatric assessments are clearly an effective tool to help us treat the whole patient. It’s a conversation starter that informs and empowers both patients...

Issues in Oncology
Geriatric Oncology

Geriatric Assessment Improves Communication Between Oncologists and Older Patients

A FEDERALLY FUNDED randomized study demonstrated that use of geriatric assessment in the routine care of older adults with advanced cancer significantly improved doctor-patient communication about age-related concerns as well as patient satisfaction with the communication. The study was presented...

Solid Tumors
Issues in Oncology
Geriatric Oncology
Lung Cancer

Chemoradiation in Elderly Patients With Stage III NSCLC Improves Overall Survival

Elderly patients with stage III non–small cell lung cancer (NSCLC) showed improved overall survival when treated with chemoradiation compared with definitive radiation alone, according to findings published by Eric D. Miller, MD, PhD, of The Ohio State University, Columbus, and colleagues in the...

Solid Tumors
Issues in Oncology
Geriatric Oncology

Does Warfarin Have Anticancer Potential in Persons Older Than Age 50?

A Norwegian population–based cohort study indicated that the use of warfarin was associated with a reduced risk of cancer overall and site-specific cancers among patients aged > 50 years. The findings were reported in JAMA Internal Medicine by Haaland et al. As noted by the investigators,...

leukemia
geriatric oncology

Courtney Denton Dinardo, MD, on AML: Treatment Study Results

Courtney Denton Dinardo, MD, of The University of Texas MD Anderson Cancer Center, discusses findings on the durable response with venetoclax in combination with decitabine or azacitidine in elderly patients with acute myeloid leukemia (Abstract 7010).

geriatric oncology

Supriya G. Mohile, MD, on Communicating With Older Cancer Patients: Results From a Community Trial

Supriya G. Mohile, MD, of the University of Rochester Medical Center, discusses study findings on ways to improve communication with older cancer patients using geriatric assessment (Abstract LBA10003).

Geriatric Oncology

A Love of Older Patients With Cancer Drives a Career Path for Arti Hurria, MD, FASCO

Arti Hurria, MD, FASCO, who is Director of City of Hope’s Center for Cancer and Aging, is a first generation of immigrant parents from India. “My parents left India and moved from England to Canarsie, Brooklyn, where I was born. When I was 8, my family moved to Southern California, partly due to...

geriatric oncology
survivorship

Arti Hurria, MD, on Survivorship Care for the Aging Population

Arti Hurria, MD, of the City of Hope, discusses ways to incorporate the principles of geriatrics into oncology care and offer targeted interventions for older survivors.

Geriatric Oncology

Broadening the Evidence Base for Older Patients: FDA-ASCO Workshop Explores Emerging Strategies

In the not-so-distant past, clinical trials were considered an option only for the young and fit. Enrolling older people “used to be thought unethical,” said Janet Woodcock, MD, Director of the U.S. Food and Drug Administration (FDA)’s Center for Drug Evaluation and Research (CDER), as she opened...

Geriatric Oncology

Clinical Trials Actively Recruiting Geriatric Oncology Patients

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on geriatric oncology. These studies highlight psychological interventions, managing cancer symptoms, the surgical process, fall prevention, and making treatment decisions; as well ...

Geriatric Oncology

Register for the Geriatric Oncology Workshop

On November 6, 2017, ASCO and the U.S. Food and Drug Administration (FDA) will hold a joint Geriatric Oncology Workshop aimed at improving the evidence base for treating the geriatric oncology population.  While more than 60% of cancers in the United States occur in people aged 65 and older, the...

Geriatric Oncology
Issues in Oncology

‘Slow, Incremental Changes’ Are Increasing Participation of Older Adults in Clinical Trials

Older adults continue to be proportionally underrepresented in oncology clinical trials, but the participation rate of adults aged 65 and older is increasing by “slow, incremental changes,” Stuart M. Lichtman, MD, FACP, FASCO, noted in an interview with The ASCO Post. Prompting those changes are...

Geriatric Oncology
Global Cancer Care

Challenges in Geriatric Oncology in Low- and Middle-Income Countries: Focus on Latin America

Virtually every region and country in the world are experiencing population aging. Although developed regions still have the largest proportion of older persons, the absolute number of older adults is higher in developing regions of the world. Globally, more than 60% of all persons aged 65 now...

Geriatric Oncology

Preparing for Future Challenges in Geriatric Surgical Oncology

In the past decade, advances in surgical oncology have been echoed in the field of geriatric oncology. The current literature regarding older people with cancer includes mainly retrospective cohort studies, focusing on alternatives to radical surgery in comorbid patients. More recently, work has...

Geriatric Oncology
Global Cancer Care

Geriatric Oncology: A Multidisciplinary Approach in a Global Environment

Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is an Attending Physician at Memorial Sloan Kettering Cancer Center, Commack, New York, and Professor of...

Geriatric Oncology

Pioneer in Geriatric Oncology, Hyman Muss, MD, Continues to Improve Care for Older Patients

Hyman Muss, MD, a pioneer in geriatric oncology, considers himself “a real Brooklyn boy.” His father was a dentist, and his uncle was a general practitioner. “They both practiced out of a small brownstone house in Brownsville-Crown Heights. It was sort of reminiscent of the famous movie The Last...

CNS Cancers
Geriatric Oncology

Optimizing Treatment for Elderly Patients With Glioblastoma

In 2005, Stupp and colleagues published their landmark paper demonstrating in a randomized phase III trial that the addition of temozolomide to radiation increased overall survival in patients with newly diagnosed glioblastoma. Notably, patients over age 70 years were excluded from this study.1...

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