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Integrating Geriatric Oncology into Clinical Pathways and Guidelines

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Geriatric Oncology

Abstract

Cancer is a disease of the elderly, and more research is needed to improve geriatric oncology care. The complexity of older cancer patients requires clinicians to consider a declining organs’ function and competing comorbidities to balance pros and cons of every treatment choice within the context of estimated life expectancy.

A comprehensive geriatric assessment (CGA) is helpful and mandatory to establish an appropriate care plan as research demonstrated it can detect issues that would remain otherwise neglected and improve the care of older cancer patients. Predictive tools for chemotherapy toxicity may also help complete the assessment for patients eligible for anticancer therapy. Nevertheless, CGA may be time-consuming, and several screening tools have been developed and validated to identify potential candidates for a full assessment.

Due to the underrepresentation of older patients in clinical trials and the shortage of studies specifically addressing this population, a solid evidence base for the management of cancer in this setting is currently lacking. However, less robust levels of evidence may be used to inform treatment decisions. Therefore, the guidelines available can provide clinicians with the tools to pilot the care of older adults with cancer, yet more specific research in the field is awaited.

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References

  • Aapro M, Bernard-Marty C, Brain EG, Batist G, Erdkamp F, Krzemieniecki K, et al. Anthracycline cardiotoxicity in the elderly cancer patient: a SIOG expert position paper. Ann Oncol. 2011;22(2):257–67.

    Article  CAS  PubMed  Google Scholar 

  • American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Patient-centered care for older adults with multiple chronic conditions: a stepwise approach from the American Geriatrics Society: American Geriatrics Society expert panel on the Care of Older Adults with multimorbidity. J Am Geriatr Soc. 2012;60(10):1957–68.

    Article  PubMed Central  Google Scholar 

  • Asmis TR, Ding K, Seymour L, Shepherd FA, Leighl NB, Winton TL, et al. Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada clinical trials group trials. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(1):54–9.

    Article  CAS  Google Scholar 

  • Baider L, Surbone A. Universality of aging: family caregivers for elderly cancer patients. Front Psychol. 2014;5:744.

    Article  PubMed  PubMed Central  Google Scholar 

  • Balducci L. Management of cancer in the elderly. Oncology (Williston Park). 2006;20(2):135–43. discussion 44, 46, 51-2

    Google Scholar 

  • Barrett-Lee PJ, Dixon JM, Farrell C, Jones A, Leonard R, Murray N, et al. Expert opinion on the use of anthracyclines in patients with advanced breast cancer at cardiac risk. Ann Oncol. 2009;20(5):816–27.

    Article  CAS  PubMed  Google Scholar 

  • Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol Off J Am Soc Clin Oncol. 2016;34(6):557–65.

    Article  CAS  Google Scholar 

  • Battisti N, Sehovic M, Extermann M. Assessment of the external validity of National Comprehensive Cancer Network and European Society for Medical Oncology guidelines for non-small cell lung cancer in a population of elderly patients aged 80 and older. J Clin Oncol. 2015;33(15_suppl (May 20 Supplement)):e20539.

    Google Scholar 

  • Bellera CA, Rainfray M, Mathoulin-Pelissier S, Mertens C, Delva F, Fonck M, et al. Screening older cancer patients: first evaluation of the G-8 geriatric screening tool. Ann Oncol. 2012;23(8):2166–72.

    Article  CAS  PubMed  Google Scholar 

  • Bellmunt J, Negrier S, Escudier B, Awada A, Aapro M. The medical treatment of metastatic renal cell cancer in the elderly: position paper of a SIOG taskforce. Crit Rev Oncol Hematol. 2009;69(1):64–72.

    Article  PubMed  Google Scholar 

  • Biganzoli L, Wildiers H, Oakman C, Marotti L, Loibl S, Kunkler I, et al. Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA). Lancet Oncol. 2012;13(4):e148–60.

    Article  PubMed  Google Scholar 

  • Biganzoli L, Lichtman S, Michel JP, Papamichael D, Quoix E, Walko C, et al. Oral single-agent chemotherapy in older patients with solid tumours: a position paper from the International Society of Geriatric Oncology (SIOG). Eur J Cancer. 2015;51(17):2491–500.

    Article  CAS  PubMed  Google Scholar 

  • Biganzoli L, Aapro M, Loibl S, Wildiers H, Brain E. Taxanes in the treatment of breast cancer: have we better defined their role in older patients? A position paper from a SIOG task force. Cancer Treat Rev. 2016;43:19–26.

    Article  CAS  PubMed  Google Scholar 

  • Body JJ, Terpos E, Tombal B, Hadji P, Arif A, Young A, et al. Bone health in the elderly cancer patient: a SIOG position paper. Cancer Treat Rev. 2016;51:46–53.

    Article  CAS  PubMed  Google Scholar 

  • Braes T, Flamaing J, Sterckx W, Lipkens P, Sabbe M, de Rooij SE, et al. Predicting the risk of functional decline in older patients admitted to the hospital: a comparison of three screening instruments. Age Ageing. 2009;38(5):600–3.

    Article  PubMed  Google Scholar 

  • Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.

    Article  CAS  PubMed  Google Scholar 

  • Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245–51.

    Article  CAS  PubMed  Google Scholar 

  • Clough-Gorr KM, Stuck AE, Thwin SS, Silliman RA. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol Off J Am Soc Clin Oncol. 2010;28(3):380–6.

    Article  Google Scholar 

  • Cohen HJ. Cancer care in the older population: physiology of aging. American Society of Clinical Oncology Curriculum. 2002.

    Google Scholar 

  • Cohen HJ. A model for the shared care of elderly patients with cancer. J Am Geriatr Soc. 2009;57(Suppl 2):S300–2.

    Article  PubMed  Google Scholar 

  • Cohen HJ, Feussner JR, Weinberger M, Carnes M, Hamdy RC, Hsieh F, et al. A controlled trial of inpatient and outpatient geriatric evaluation and management. N Engl J Med. 2002;346(12):905–12.

    Article  PubMed  Google Scholar 

  • Coleman EA, Smith JD, Raha D, Min SJ. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005;165(16):1842–7.

    Article  PubMed  Google Scholar 

  • Cunningham D, Lang I, Marcuello E, Lorusso V, Ocvirk J, Shin DB, et al. Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial. Lancet Oncol. 2013;14(11):1077–85.

    Article  CAS  PubMed  Google Scholar 

  • Decoster L, Kenis C, Van Puyvelde K, Flamaing J, Conings G, De Greve J, et al. The influence of clinical assessment (including age) and geriatric assessment on treatment decisions in older patients with cancer. J Geriatr Oncol. 2013;4(3):235–41.

    Article  PubMed  Google Scholar 

  • Decoster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G, et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendationsdagger. Ann Oncol. 2015;26(2):288–300.

    Article  CAS  PubMed  Google Scholar 

  • Denegri A, Moccetti T, Moccetti M, Spallarossa P, Brunelli C, Ameri P. Cardiac toxicity of trastuzumab in elderly patients with breast cancer. J Geriatr Cardiol. 2016;13(4):355–63.

    PubMed  PubMed Central  Google Scholar 

  • Denlinger CS, Ligibel JA, Are M, Baker KS, Broderick G, Demark-Wahnefried W, et al. NCCN guidelines insights: survivorship, version 1.2016. J Natl Compr Cancer Netw. 2016;14(6):715–24.

    Article  Google Scholar 

  • Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern cooperative oncology group. Am J Med. 1980;69(4):491–7.

    Article  CAS  PubMed  Google Scholar 

  • Di Maio M, Gallo C, Leighl NB, Piccirillo MC, Daniele G, Nuzzo F, et al. Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials. J Clin Oncol Off J Am Soc Clin Oncol. 2015;33(8):910–5.

    Article  CAS  Google Scholar 

  • Droz JP, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, et al. Management of prostate cancer in older patients: updated recommendations of a working group of the International Society of Geriatric Oncology. Lancet Oncol. 2014;15(9):e404–14.

    Article  PubMed  Google Scholar 

  • ePrognosis. n.d.. Available from http://eprognosis.ucsf.edu/.

  • Ewer MS, Lenihan DJ. Left ventricular ejection fraction and cardiotoxicity: is our ear really to the ground? J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(8):1201–3.

    Article  Google Scholar 

  • Extermann M. Management issues for elderly patients with breast cancer. Curr Treat Options in Oncol. 2004;5(2):161–9.

    Article  Google Scholar 

  • Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2007;25(14):1824–31.

    Article  Google Scholar 

  • Extermann M, Overcash J, Lyman GH, Parr J, Balducci L. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol Off J Am Soc Clin Oncol. 1998;16(4):1582–7.

    Article  CAS  Google Scholar 

  • Extermann M, Meyer J, McGinnis M, Crocker TT, Corcoran MB, Yoder J, et al. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Crit Rev Oncol Hematol. 2004;49(1):69–75.

    Article  PubMed  Google Scholar 

  • Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz JP, Lichtman S, et al. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005;55(3):241–52.

    Article  PubMed  Google Scholar 

  • Extermann M, Boler I, Reich RR, Lyman GH, Brown RH, DeFelice J, et al. Predicting the risk of chemotherapy toxicity in older patients: the chemotherapy risk assessment scale for high-age patients (CRASH) score. Cancer. 2012;118(13):3377–86.

    Article  PubMed  Google Scholar 

  • Foster JA, Salinas GD, Mansell D, Williamson JC, Casebeer LL. How does older age influence oncologists’ cancer management? Oncologist. 2010;15(6):584–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Freyer G, Geay JF, Touzet S, Provencal J, Weber B, Jacquin JP, et al. Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: a GINECO study. Ann Oncol. 2005;16(11):1795–800.

    Article  CAS  PubMed  Google Scholar 

  • Germain V, Dabakuyo-Yonli TS, Marilier S, Putot A, Bengrine-Lefevre L, Arveux P, et al. Management of elderly patients suffering from cancer: assessment of perceived burden and of quality of life of primary caregivers. J Geriatr Oncol. 2016;8(3):220–8.

    Article  PubMed  Google Scholar 

  • Ghignone F, van Leeuwen BL, Montroni I, Huisman MG, Somasundar P, Cheung KL, et al. The assessment and management of older cancer patients: a SIOG surgical task force survey on surgeons' attitudes. Eur J Surg Oncol. 2016;42(2):297–302.

    Article  CAS  PubMed  Google Scholar 

  • Giovanazzi-Bannon S, Rademaker A, Lai G, Benson AB 3rd. Treatment tolerance of elderly cancer patients entered onto phase II clinical trials: an Illinois cancer center study. J Clin Oncol Off J Am Soc Clin Oncol. 1994;12(11):2447–52.

    Article  CAS  Google Scholar 

  • Gorin SS, Heck JE, Albert S, Hershman D. Treatment for breast cancer in patients with Alzheimer’s disease. J Am Geriatr Soc. 2005;53(11):1897–904.

    Article  PubMed  Google Scholar 

  • Gupta SK, Lamont EB. Patterns of presentation, diagnosis, and treatment in older patients with colon cancer and comorbid dementia. J Am Geriatr Soc. 2004;52(10):1681–7.

    Article  PubMed  Google Scholar 

  • Hamerman D. Toward an understanding of frailty. Ann Intern Med. 1999;130(11):945–50.

    Article  CAS  PubMed  Google Scholar 

  • Hershman DL, McBride RB, Eisenberger A, Tsai WY, Grann VR, Jacobson JS. Doxorubicin, cardiac risk factors, and cardiac toxicity in elderly patients with diffuse B-cell non-Hodgkin’s lymphoma. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(19):3159–65.

    Article  CAS  Google Scholar 

  • Hershman DL, Lacchetti C, Dworkin RH, Lavoie Smith EM, Bleeker J, Cavaletti G, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(18):1941–67.

    Article  CAS  Google Scholar 

  • Hershman DL, Till C, Wright JD, Awad D, Ramsey SD, Barlow WE, et al. Comorbidities and risk of chemotherapy-induced peripheral neuropathy among participants 65 years or older in southwest oncology group clinical trials. J Clin Oncol. 2016;34(25):3014–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hines RB, Chatla C, Bumpers HL, Waterbor JW, McGwin G Jr, Funkhouser E, et al. Predictive capacity of three comorbidity indices in estimating mortality after surgery for colon cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2009;27(26):4339–45.

    Article  Google Scholar 

  • Hoppe S, Rainfray M, Fonck M, Hoppenreys L, Blanc JF, Ceccaldi J, et al. Functional decline in older patients with cancer receiving first-line chemotherapy. J Clin Oncol Off J Am Soc Clin Oncol. 2013;31(31):3877–82.

    Article  Google Scholar 

  • Hsu T. Educational initiatives in geriatric oncology - who, why, and how? J Geriatr Oncol. 2016;7(5):390–6.

    Article  PubMed  Google Scholar 

  • Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29(25):3457–65.

    Article  CAS  Google Scholar 

  • Hurria A, Wildes T, Blair SL, Browner IS, Cohen HJ, Deshazo M, et al. Senior adult oncology, version 2.2014: clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2014a;12(1):82–126.

    Article  Google Scholar 

  • Hurria A, Dale W, Mooney M, Rowland JH, Ballman KV, Cohen HJ, et al. Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations. J Clin Oncol. 2014b;32(24):2587–94.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hurria A, Levit LA, Dale W, Mohile SG, Muss HB, Fehrenbacher L, et al. Improving the evidence base for treating older adults with cancer: American Society of Clinical Oncology statement. J Clin Oncol Off J Am Soc Clin Oncol. 2015;33(32):3826–33.

    Article  Google Scholar 

  • Hurria A, Mohile S, Gajra A, Klepin H, Muss H, Chapman A, et al. Validation of a prediction tool for chemotherapy toxicity in older adults with cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2016;34(20):2366–71.

    Article  Google Scholar 

  • Hutchins LF, Unger JM, Crowley JJ, Coltman CA Jr, Albain KS. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med. 1999;341(27):2061–7.

    Article  CAS  PubMed  Google Scholar 

  • Ingram SS, Seo PH, Martell RE, Clipp EC, Doyle ME, Montana GS, et al. Comprehensive assessment of the elderly cancer patient: the feasibility of self-report methodology. J Clin Oncol Off J Am Soc Clin Oncol. 2002;20(3):770–5.

    Article  Google Scholar 

  • Javid SH, Unger JM, Gralow JR, Moinpour CM, Wozniak AJ, Goodwin JW, et al. A prospective analysis of the influence of older age on physician and patient decision-making when considering enrollment in breast cancer clinical trials (SWOG S0316). Oncologist. 2012;17(9):1180–90.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jenkins V, Farewell V, Farewell D, Darmanin J, Wagstaff J, Langridge C, et al. Drivers and barriers to patient participation in RCTs. Br J Cancer. 2013;108(7):1402–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jolly TA, Deal AM, Nyrop KA, Williams GR, Pergolotti M, Wood WA, et al. Geriatric assessment-identified deficits in older cancer patients with normal performance status. Oncologist. 2015;20(4):379–85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kemeny MM, Peterson BL, Kornblith AB, Muss HB, Wheeler J, Levine E, et al. Barriers to clinical trial participation by older women with breast cancer. J Clin Oncol. 2003;21(12):2268–75.

    Article  PubMed  Google Scholar 

  • Kenis C, Bron D, Libert Y, Decoster L, Van Puyvelde K, Scalliet P, et al. Relevance of a systematic geriatric screening and assessment in older patients with cancer: results of a prospective multicentric study. Ann Oncol. 2013;24(5):1306–12.

    Article  CAS  PubMed  Google Scholar 

  • Ketelaars L, Pottel L, Lycke M, Goethals L, Ghekiere V, Santy L, et al. Use of the Freund clock drawing test within the mini-cog as a screening tool for cognitive impairment in elderly patients with or without cancer. J Geriatr Oncol. 2013;4(2):174–82.

    Article  PubMed  Google Scholar 

  • Klepin HD, Rodin M, Hurria A. Treating older adults with cancer: geriatric perspectives. Am Soc Clin Oncol Educ Book. 2015:e544–52.

    Google Scholar 

  • Kua J. The prevalence of psychological and psychiatric sequelae of cancer in the elderly – how much do we know? Ann Acad Med Singap. 2005;34(3):250–6.

    CAS  PubMed  Google Scholar 

  • Launay-Vacher V, Chatelut E, Lichtman SM, Wildiers H, Steer C, Aapro M. Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations. Ann Oncol. 2007;18(8):1314–21.

    Article  CAS  PubMed  Google Scholar 

  • Lewis JH, Kilgore ML, Goldman DP, Trimble EL, Kaplan R, Montello MJ, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol Off J Am Soc Clin Oncol. 2003;21(7):1383–9.

    Article  Google Scholar 

  • Lichtman SM, Villani G. Chemotherapy in the elderly: pharmacologic considerations. Cancer Control. 2000;7(6):548–56.

    Article  CAS  PubMed  Google Scholar 

  • LoConte NK, Smith M, Alberti D, Bozeman J, Cleary JF, Setala AN, et al. Amongst eligible patients, age and comorbidity do not predict for dose-limiting toxicity from phase I chemotherapy. Cancer Chemother Pharmacol. 2010;65(4):775–80.

    Article  PubMed  Google Scholar 

  • Lycke M, Ketelaars L, Boterberg T, Pottel L, Pottel H, Vergauwe P, et al. Validation of the Freund clock drawing test as a screening tool to detect cognitive dysfunction in elderly cancer patients undergoing comprehensive geriatric assessment. Psycho-Oncology. 2014;23(10):1172–7.

    Article  PubMed  Google Scholar 

  • Maggiore RJ, Callahan KE, Tooze JA, Parker IR, Hsu T, Klepin HD. Geriatrics fellowship training and the role of geriatricians in older adult cancer care: a survey of geriatrics fellowship directors. Gerontol Geriatr Educ. 2016;17:1–13.

    Article  Google Scholar 

  • Magnuson A, Dale W, Mohile S. Models of Care in Geriatric Oncology. Curr Geriatr Rep. 2014;3(3):182–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Maione P, Perrone F, Gallo C, Manzione L, Piantedosi F, Barbera S, et al. Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(28):6865–72.

    Article  Google Scholar 

  • Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the cumulative illness rating scale. Psychiatry Res. 1992;41(3):237–48.

    Article  CAS  PubMed  Google Scholar 

  • Mohile SG, Xian Y, Dale W, Fisher SG, Rodin M, Morrow GR, et al. Association of a cancer diagnosis with vulnerability and frailty in older Medicare beneficiaries. J Natl Cancer Inst. 2009;101(17):1206–15.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mohile SG, Velarde C, Hurria A, Magnuson A, Lowenstein L, Pandya C, et al. Geriatric assessment-guided care processes for older adults: a Delphi consensus of geriatric oncology experts. J Natl Compr Cancer Netw. 2015;13(9):1120–30.

    Article  Google Scholar 

  • Mohile SG, Hurria A, Cohen HJ, Rowland JH, Leach CR, Arora NK, et al. Improving the quality of survivorship for older adults with cancer. Cancer. 2016;122(16):2459–568.

    Article  PubMed  PubMed Central  Google Scholar 

  • Monfardini S, Balducci L. A comprehensive geriatric assessment (CGA) is necessary for the study and the management of cancer in the elderly. Eur J Cancer. 1999;35(13):1771–2.

    Article  CAS  PubMed  Google Scholar 

  • Monfardini S, Ferrucci L, Fratino L, del Lungo I, Serraino D, Zagonel V. Validation of a multidimensional evaluation scale for use in elderly cancer patients. Cancer. 1996;77(2):395–401.

    Article  CAS  PubMed  Google Scholar 

  • Morgan B, Tarbi E. The role of the advanced practice nurse in geriatric oncology care. Semin Oncol Nurs. 2016;32(1):33–43.

    Article  PubMed  Google Scholar 

  • Morrison VA, Hamlin P, Soubeyran P, Stauder R, Wadhwa P, Aapro M, et al. Diffuse large B-cell lymphoma in the elderly: impact of prognosis, comorbidities, geriatric assessment, and supportive care on clinical practice. An International Society of Geriatric Oncology (SIOG) expert position paper. J Geriatr Oncol. 2015;6(2):141–52.

    Article  PubMed  Google Scholar 

  • Muss HB, Berry DA, Cirrincione CT, Theodoulou M, Mauer AM, Kornblith AB, et al. Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med. 2009;360(20):2055–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • National Coalition for Cancer Survivorship. 12 Apr 2016. Available from http://www.canceradvocacy.org/.

  • Navaie-Waliser M, Feldman PH, Gould DA, Levine C, Kuerbis AN, Donelan K. When the caregiver needs care: the plight of vulnerable caregivers. Am J Public Health. 2002;92(3):409–13.

    Article  PubMed  PubMed Central  Google Scholar 

  • Neale R, Brayne C, Johnson AL. Cognition and survival: an exploration in a large multicentre study of the population aged 65 years and over. Int J Epidemiol. 2001;30(6):1383–8.

    Article  CAS  PubMed  Google Scholar 

  • Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP. Weight change in old age and its association with mortality. J Am Geriatr Soc. 2001;49(10):1309–18.

    Article  CAS  PubMed  Google Scholar 

  • Nightingale G, Hajjar E, Swartz K, Andrel-Sendecki J, Chapman A. Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2015;33(13):1453–9.

    Article  Google Scholar 

  • Overcash JA, Beckstead J, Extermann M, Cobb S. The abbreviated comprehensive geriatric assessment (aCGA): a retrospective analysis. Crit Rev Oncol Hematol. 2005;54(2):129–36.

    Article  PubMed  Google Scholar 

  • Pallis AG, Gridelli C, Wedding U, Faivre-Finn C, Veronesi G, Jaklitsch M, et al. Management of elderly patients with NSCLC; updated expert's opinion paper: EORTC elderly task force, lung cancer group and International Society for Geriatric Oncology. Ann Oncol. 2014;25(7):1270–83.

    Article  CAS  PubMed  Google Scholar 

  • Papamichael D, Audisio RA, Glimelius B, de Gramont A, Glynne-Jones R, Haller D, et al. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013. Ann Oncol. 2015;26(3):463–76.

    Article  CAS  PubMed  Google Scholar 

  • Parry C, Kent EE, Mariotto AB, Alfano CM, Rowland JH. Cancer survivors: a booming population. Cancer Epidemiol Biomark Prev. 2011;20(10):1996–2005.

    Article  Google Scholar 

  • Penninx BW, Guralnik JM, Ferrucci L, Simonsick EM, Deeg DJ, Wallace RB. Depressive symptoms and physical decline in community-dwelling older persons. JAMA. 1998;279(21):1720–6.

    Article  CAS  PubMed  Google Scholar 

  • Peterson LL, Hurria A, Feng T, Mohile SG, Owusu C, Klepin HD, et al. Association between renal function and chemotherapy-related toxicity in older adults with cancer. J Geriatr Oncol. 2016;8(2):96–101.

    Article  PubMed  Google Scholar 

  • Petit-Moneger A, Rainfray M, Soubeyran P, Bellera CA, Mathoulin-Pelissier S. Detection of frailty in elderly cancer patients: improvement of the G8 screening test. J Geriatr Oncol. 2016;7(2):99–107.

    Article  PubMed  Google Scholar 

  • Pinder MC, Duan Z, Goodwin JS, Hortobagyi GN, Giordano SH. Congestive heart failure in older women treated with adjuvant anthracycline chemotherapy for breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2007;25(25):3808–15.

    Article  CAS  Google Scholar 

  • Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, et al. Serial comprehensive geriatric assessment in elderly head and neck cancer patients undergoing curative radiotherapy identifies evolution of multidimensional health problems and is indicative of quality of life. Eur J Cancer Care. 2014;23(3):401–12.

    Article  CAS  Google Scholar 

  • Presley CJ, Dotan E, Soto-Perez-de-Celis E, Jatoi A, Mohile SG, Won E, et al. Gaps in nutritional research among older adults with cancer. J Geriatr Oncol. 2016;7(4):281–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ramjaun A, Nassif MO, Krotneva S, Huang AR, Meguerditchian AN. Improved targeting of cancer care for older patients: a systematic review of the utility of comprehensive geriatric assessment. J Geriatr Oncol. 2013;4(3):271–81.

    Article  PubMed  Google Scholar 

  • Rao AV, Hsieh F, Feussner JR, Cohen HJ. Geriatric evaluation and management units in the care of the frail elderly cancer patient. J Gerontol A Biol Sci Med Sci. 2005;60(6):798–803.

    Article  PubMed  Google Scholar 

  • Repetto L, Balducci LA. Case for geriatric oncology. Lancet Oncol. 2002;3(5):289–97.

    Article  PubMed  Google Scholar 

  • Repetto L, Fratino L, Audisio RA, Venturino A, Gianni W, Vercelli M, et al. Comprehensive geriatric assessment adds information to eastern cooperative oncology group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study. J Clin Oncol Off J Am Soc Clin Oncol. 2002;20(2):494–502.

    Article  Google Scholar 

  • Reuben DB, Frank JC, Hirsch SH, McGuigan KA, Maly RC. A randomized clinical trial of outpatient comprehensive geriatric assessment coupled with an intervention to increase adherence to recommendations. J Am Geriatr Soc. 1999;47(3):269–76.

    Article  CAS  PubMed  Google Scholar 

  • Ries EM, Kosary CL, Hankey BF. SEER cancer statistics review: 1975–2000. Bethesda: National Cancer Institute; 2003.

    Google Scholar 

  • Rolland Y, Lauwers-Cances V, Cristini C, Abellan van Kan G, Janssen I, Morley JE, et al. Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l'OSteoporose) study. Am J Clin Nutr. 2009;89(6):1895–900.

    Article  CAS  PubMed  Google Scholar 

  • Rowland JH, Bellizzi KM. Cancer survivorship issues: life after treatment and implications for an aging population. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(24):2662–8.

    Article  Google Scholar 

  • Saliba D, Elliott M, Rubenstein LZ, Solomon DH, Young RT, Kamberg CJ, et al. The vulnerable elders survey: a tool for identifying vulnerable older people in the community. J Am Geriatr Soc. 2001;49(12):1691–9.

    Article  CAS  PubMed  Google Scholar 

  • Sanoff HK, Goldberg RM, Pignone MP. A systematic review of the use of quality of life measures in colorectal cancer research with attention to outcomes in elderly patients. Clin Colorectal Cancer. 2007;6(10):700–9.

    Article  PubMed  Google Scholar 

  • Satariano WA, Ragland DR. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med. 1994;120(2):104–10.

    Article  CAS  PubMed  Google Scholar 

  • Sattar S, Alibhai SM, Wildiers H, Puts MT. How to implement a geriatric assessment in your clinical practice. Oncologist. 2014;19(10):1056–68.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sattar S, Alibhai SM, Spoelstra SL, Fazelzad R. Puts MT. falls in older adults with cancer: a systematic review of prevalence, injurious falls, and impact on cancer treatment. Support Care Cancer. 2016;24(10):4459–69.

    Article  PubMed  Google Scholar 

  • Sawhney R, Sehl M, Naeim A. Physiologic aspects of aging: impact on cancer management and decision making, part I. ancer J. 2005;11(6):449–60.

    Google Scholar 

  • Schneider BP, Hershman DL, Loprinzi C. Symptoms: chemotherapy-induced peripheral neuropathy. Adv Exp Med Biol. 2015;862:77–87.

    Article  PubMed  Google Scholar 

  • Schroeck JL, Ford J, Conway EL, Kurtzhalts KE, Gee ME, Vollmer KA, et al. Review of safety and efficacy of sleep medicines in older adults. Clin Ther. 2016;38(11):2340–72.

    Article  CAS  PubMed  Google Scholar 

  • Sehl M, Sawhney R, Naeim A. Physiologic aspects of aging: impact on cancer management and decision making, part II. Cancer J. 2005;11(6):461–73.

    Article  PubMed  Google Scholar 

  • Serraino D, Fratino L, Zagonel V. Prevalence of functional disability among elderly patients with cancer. Crit Rev Oncol Hematol. 2001;39(3):269–73.

    Article  CAS  PubMed  Google Scholar 

  • Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758–65.

    Article  PubMed  Google Scholar 

  • Soubeyran P, Fonck M, Blanc-Bisson C, Blanc JF, Ceccaldi J, Mertens C, et al. Predictors of early death risk in older patients treated with first-line chemotherapy for cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2012;30(15):1829–34.

    Article  Google Scholar 

  • Soubeyran P, Bellera C, Goyard J, Heitz D, Cure H, Rousselot H, et al. Screening for vulnerability in older cancer patients: the ONCODAGE prospective multicenter cohort study. PLoS One. 2014;9(12):e115060.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Stauder R, Eichhorst B, Hamaker M, Kaplanov K, Morrison V, Osterborg A, et al. Management of Chronic Lymphocytic Leukemia (CLL) in the elderly: a position paper from an International Society of Geriatric Oncology (SIOG) task force. Ann Oncol. 2016;28(2):218–27.

    Google Scholar 

  • Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993;342(8878):1032–6.

    Article  CAS  PubMed  Google Scholar 

  • Thompson K, Dale W. How do I best manage the care of older patients with cancer with multimorbidity? J Geriatr Oncol. 2015;6(4):249–53.

    Article  PubMed  Google Scholar 

  • Townsley CA, Selby R, Siu LL. Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials. J Clin Oncol. 2005;23(13):3112–24.

    Article  PubMed  Google Scholar 

  • Townsley CA, Chan KK, Pond GR, Marquez C, Siu LL, Straus SE. Understanding the attitudes of the elderly towards enrolment into cancer clinical trials. BMC Cancer. 2006;6:34.

    Article  PubMed  PubMed Central  Google Scholar 

  • Trimble EL, Carter CL, Cain D, Freidlin B, Ungerleider RS, Friedman MA. Representation of older patients in cancer treatment trials. Cancer. 1994;74(7 Suppl):2208–14.

    Article  CAS  PubMed  Google Scholar 

  • VanderWalde N, Jagsi R, Dotan E, Baumgartner J, Browner IS, Burhenn P, et al. NCCN guidelines insights: older adult oncology, version 2.2016. J Natl Compr Cancer Netw. 2016;14(11):1357–70.

    Article  Google Scholar 

  • Vestal RE. Aging and pharmacology. Cancer. 1997;80(7):1302–10.

    Article  CAS  PubMed  Google Scholar 

  • Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6.

    Article  CAS  PubMed  Google Scholar 

  • WHO. World population aging 1950–2050. Geneva: WHO, Department of Economic and Social Affairs Population Division; 2002.

    Google Scholar 

  • Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2014;32(24):2595–603.

    Article  Google Scholar 

  • Williams GR, Mackenzie A, Magnuson A, Olin R, Chapman A, Mohile S, et al. Comorbidity in older adults with cancer. J Geriatr Oncol. 2016;7(4):249–57.

    Article  PubMed  Google Scholar 

  • Wolfson C, Wolfson DB, Asgharian M, M'Lan CE, Ostbye T, Rockwood K, et al. A reevaluation of the duration of survival after the onset of dementia. N Engl J Med. 2001;344(15):1111–6.

    Article  CAS  PubMed  Google Scholar 

  • Yee KW, Pater JL, Pho L, Zee B, Siu LL. Enrollment of older patients in cancer treatment trials in Canada: why is age a barrier? J Clin Oncol Off J Am Soc Clin Oncol. 2003;21(8):1618–23.

    Article  Google Scholar 

  • Yellen SB, Cella DF, Leslie WT. Age and clinical decision making in oncology patients. J Natl Cancer Inst. 1994;86(23):1766–70.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine – Breast Unit, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK

    Nicolò Matteo Luca Battisti

  2. Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Efrat Dotan

Authors
  1. Nicolò Matteo Luca Battisti
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  2. Efrat Dotan
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Correspondence to Nicolò Matteo Luca Battisti .

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Editors and Affiliations

  1. Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA

    Martine Extermann

Section Editor information

  1. Senior Adult Oncology Program, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA

    Martine Extermann Md, PhD

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Battisti, N.M.L., Dotan, E. (2018). Integrating Geriatric Oncology into Clinical Pathways and Guidelines. In: Extermann, M. (eds) Geriatric Oncology . Springer, Cham. https://doi.org/10.1007/978-3-319-44870-1_18-1

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  • DOI: https://doi.org/10.1007/978-3-319-44870-1_18-1

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