Abstract:
OBJECTIVE:Elderly patients with cancer are under-represented in clinical trials, and there is especially scant data on their participation in early-phase trials. In an effort to provide more data, we reviewed our Phase I experience. METHODS:We conducted a retrospective analysis of 461 patients enrolled in Phase I clinical trials at the Cancer Therapy Research Center (CTRC) from 2009 to 2011 to determine the rate of completion of at least 12 weeks of treatment, incidence of adverse events, prevalence of co-morbidities, functional status, and survival. Elderly (E) was defined as ≥70 years; non-elderly (NE) was defined as ≤69 years. RESULTS:The elderly represented 15% (69/461) of enrolled patients. The most common malignancies were colon (20%), hematologic (18%), lung (15%), and breast (8%). The median age of E was 72 years (range 70-85, SD 3.15), and 49% of the E was female. Co-morbidities (E vs. NE) include diabetes (28% vs. 23%), hypertension (65% vs. 44%), and chronic kidney disease (91% vs. 48%). Thirty-two percent of E vs. 37% of NE completed at least 12 weeks of treatment. Reasons for not completing in E vs. NE respectively were progression of disease (43% vs. 61%), toxicity (28% vs. 9%), and self-withdrawal (11% vs. 7%). Reasons for not completing the protocol was significantly associated with being elderly (p = 0.005). There were non-significant differences in toxicity in E vs. NE CONCLUSION:Elderly patients have a higher likelihood of not completing trials for reasons including toxicity. This highlights the need for better Phase I trial-designs incorporating ideal geriatric assessment tools.
journal_name
J Geriatr Oncoljournal_title
Journal of geriatric oncologyauthors
Rowe J,Patel S,Mazo-Canola M,Parra A,Goros M,Michalek J,Kelly K,Weitman S,Karnad Adoi
10.1016/j.jgo.2013.08.005subject
Has Abstractpub_date
2014-01-01 00:00:00pages
65-70issue
1eissn
1879-4068issn
1879-4076pii
S1879-4068(13)00087-8journal_volume
5pub_type
杂志文章abstract::Median age at bladder cancer (BC) diagnosis is older than for other major tumours. Age should not determine treatment, and patients should be fully involved in decisions. Patients should be screened with Mini-Cog™ for cognitive impairment and the G8 to ascertain need for comprehensive geriatric assessment. In non-musc...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2020.02.001
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:Older patients with cancer have increased risk for comorbidity, polypharmacy (PP) and drug related problems (DRP). The aim of this study was to assess the effect of a clinical pharmacist and geriatrician medication review (MR) among older outpatients with cancer to optimize management of comorbidities during...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.07.010
更新日期:2021-01-01 00:00:00
abstract:AIMS:To study age-related persistence in postmenopausal women with endocrine-responsive breast cancer treated with tamoxifen (TAM) and aromatase inhibitors (AI). METHODS:Data on 29,245 patients diagnosed with metastatic or non-metastatic breast cancer (BC) and initially treated with TAM or AI between 2004 and 2013 wer...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.03.001
更新日期:2016-05-01 00:00:00
abstract::Multidisciplinary teams (MDTs) have been incorporated into the practical care of elderly patients with cancer. Several geriatric oncology centres have attempted to determine the best way to implement MDTs by using geriatric assessment (GA). Developing a geriatric oncology service is a feasible work, which requires sig...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2016.07.001
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. MATERIALS AND METHODS:The 30-item GAH scale...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jgo.2015.03.003
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:No tools accurately discriminate between older patients who are fit and those who are frail to tolerate systemic palliative treatment. This study evaluates whether domains of geriatric assessment (GA) are associated with increased risk of chemotherapy intolerance in patients who were considered fit to start ...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.05.016
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:This study aims to identify Comprehensive Geriatric Assessment (CGA) based risk factors to help predict caregiver burden among elderly patients with cancer. MATERIALS AND METHOD:The study evaluated 249 patients newly diagnosed with cancer, aged 70years and above, who attended the geriatric oncology clinic at...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.03.003
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:Family caregiver burden among older adults with advanced cancer remains poorly understood. We sought to (1) identify patient factors associated with caregiver burden and (2) examine how amount of time caregiving modifies these relationships. METHODS:Cross-sectional analysis of baseline data from a cluster-r...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2021.01.002
更新日期:2021-01-18 00:00:00
abstract:OBJECTIVE:To date, most comorbidity studies have analyzed either a subgroup of frequent diseases, or used summary instruments such as the Charlson score or the Cumulative Illness Rating Scale-Geriatric (CIRS-G). Yet, comorbidity is a multidimensional construct and impacts function, treatment tolerance, and survival. We...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2017.07.005
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:The majority of patients with chronic lymphocytic leukemia (CLL) are older and have multiple comorbidities, including other cancer diagnoses. These patients are routinely excluded from participation in clinical trials. OBJECTIVE:In this phase II study, we determined the activity and toxicity of ofatumumab, ...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.04.002
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:Older patients with metastatic renal cell carcinoma (mRCC) were underrepresented in pivotal trials. MATERIALS AND METHODS:Consecutive patients with mRCC treated at Aarhus University Hospital with first line tyrosine kinase inhibitors (TKI), mTOR inhibitors, or checkpoint immunotherapy (CPI) were retrospecti...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.12.008
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:Older patients are at risk for adverse outcomes after surgical treatment of cancer. Identifying patients at risk could affect treatment decisions and prevent functional decline. Screening tools are available to select patients for Geriatric Assessment. Until now their predictive value for adverse outcomes in...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jgo.2017.09.003
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:Older adults frequently experience falls, at great cost to themselves and society. Older adults with cancer may be at greater risk for falls and have unique risk factors. MATERIALS AND METHODS:We undertook a systematic review of the available medical literature to examine the current evidence regarding fact...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2014.10.003
更新日期:2015-01-01 00:00:00
abstract::The "Cadillac Study" was the term Arti Hurria, MD often used to articulate her vision of the optimal study to investigate the effects of cancer and its treatments on aging trajectories. In her opinion, this study needed to be designed for near-term clinical translation and have the ability to discern subpopulations of...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2019.06.009
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Geriatric assessment (GA) is an appropriate method for identifying frailty in older patients with cancer, but a shorter instrument may be easier to use in clinical practice. Clinical judgment is always available and requires no investments in time or resources. The purpose of this study was to assess correla...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.05.011
更新日期:2020-09-01 00:00:00
abstract::With a median age of 70 years at diagnosis, lung cancer is a disease of older persons. As a consequence oncologists are confronted with an increasing older lung cancer population for which treatment decisions are needed. In the past years, the therapeutic landscape of advanced non-small cell lung cancer (NSCLC) has ch...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2018.09.008
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Cancer in the aging population presents manifold challenges. In the resource-limited settings of developing countries, concrete steps to optimize care for older adults with cancer are required. MATERIALS AND METHOD:This prospective, observational study was divided in two parts. In the first part, older adul...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.04.013
更新日期:2021-01-01 00:00:00
abstract::OBJECTIVES: To identify patient characteristics associated with polypharmacy and inappropriate medication (PIM) use among older patients with newly diagnosed cancer. DESIGN: Cross-Sectional Study. SETTING: Ambulatory oncology clinics at an academic medical center. PARTICIPANTS: 117 patients aged ≥ 65 years with new...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2012.02.005
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:In this study, we evaluated the Groningen Frailty Indicator (GFI) and the G8 questionnaire as screening tools for a Comprehensive Geriatric Assessment (CGA) in older patients with cancer. PATIENTS AND METHODS:Eligible patients with various types and stages of cancer were evaluated for frailty before treatmen...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jgo.2012.08.001
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:The influence of older age at diagnosis in combination with race/ethnicity on utilization and results of the 21-gene recurrence score (RS) assay for breast cancer (BC) patients is not fully understood. Our objectives were to evaluate the utilization of RS among older women with BC, the likelihood of a high-r...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.06.004
更新日期:2020-07-07 00:00:00
abstract:OBJECTIVE:Clinical trials investigating breast cancer treatment often exclude or misrepresent older adults. This study compares treatment patterns and survival of older women diagnosed with breast cancer between a Dutch and a British observational cohort. MATERIALS AND METHODS:Women aged 70 years and older diagnosed w...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2018.05.004
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:Little is known about how psychosocial factors and distress affect older patients with cancer and their survival. The study goals were to: 1) observe the prevalence of anxiety (ANX) and depression (DEP) symptoms at diagnosis in patients aged ≥65 years, 2) observe the association between social isolation (iso...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2020.10.001
更新日期:2020-11-04 00:00:00
abstract:BACKGROUND:Adjuvant! Online is a tool used for clinical decision making in patients with early stage colon cancer. As details of the tool's construction are not published, the ability of Adjuvant! Online to accurately predict outcomes for older patients (age 70+) with node positive colon cancer receiving adjuvant chemo...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.07.002
更新日期:2016-11-01 00:00:00
abstract::The authors regret: A calculation error was corrected in Table 3. As mentioned under the table, the percentage of patients under ‘Baseline’ was calculated from the total no. of patients with geriatric recommendations data (n = 932 pts). This was mistakenly calculated from the number of patients with available GA data ...
journal_title:Journal of geriatric oncology
pub_type: 已发布勘误
doi:10.1016/j.jgo.2016.01.005
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Management of early breast cancer in the elderly population is challenging due to different breast cancer biology and limited tolerance to aggressive treatments. The aim of this study is to evaluate whether the omission of axillary staging impacts breast cancer outcomes in elderly patients. PATIENTS AND M...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jgo.2016.12.003
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:The G8 is a screening test to identify frail elderly patients with cancer. Objectives were to design and evaluate the performance of alternative tests taking into account other predictive domains for frailty. METHODS:We conducted a literature review to identify predictive factors of frailty. Using a Delphi c...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2016.01.004
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Screening tools are used in geriatric oncology to determine who should receive a Comprehensive Geriatric Assessment (CGA). However, in this prospective study, we evaluated the association between geriatric screening results, measured with the G8 and Groningen Frailty Indicator (GFI), and severe treatment tox...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2013.12.004
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screening. MATERIALS AND METHODS:We conducted interviews with adults >65 years old with at least two chronic conditions who were taking ≥five medications daily. Patients were first asked how age and multimo...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章
doi:10.1016/j.jgo.2014.12.001
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:Assess the utility of the G8 screening tool and CGA for older adults with head and neck cancer. METHODS:Patients 65years or older with a primary malignancy of the head and neck region were presented at the multidisciplinary team (MDT) meeting. The Geriatric 8 (G8) questionnaire was administered prior. Clinic...
journal_title:Journal of geriatric oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jgo.2016.05.006
更新日期:2016-11-01 00:00:00
abstract::In advising the optimal management for older patients, health care professionals try to balance the risks from frailty, vulnerability, and comorbidity against the patient's ultimate prognosis, potential functional outcomes and quality of life (QOL). At the same time it is important to involve the patient and incorpora...
journal_title:Journal of geriatric oncology
pub_type: 杂志文章,评审
doi:10.1016/j.jgo.2018.08.001
更新日期:2018-11-01 00:00:00