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Journal of Geriatric Oncology

Matti Aapro, Karin Jordan, Richard J Gralla, Giada Rizzi, Giorgia Rossi, Marco Palmas, Anna V Alyasova, Alla S Lisyanskaya, Snežana M Bošnjak, Paul J Hesketh
OBJECTIVES: Prevention of chemotherapy-induced nausea and vomiting is critical in older cancer patients. NEPA is an oral fixed combination of netupitant 300mg, a new NK1 receptor antagonist (RA), and palonosetron 0.5mg, a pharmacologically distinct 5-HT3 RA. This retrospective analysis evaluated the efficacy and safety of NEPA in older patients. METHODS: Patients aged ≥65 and ≥70years from one phase II and two phase III trials were considered. Chemotherapy-naive patients with malignant tumors were treated with anthracycline-cyclophosphamide (AC), non-AC-based moderately emetogenic chemotherapy (non-AC MEC), or highly emetogenic chemotherapy (HEC)...
November 23, 2016: Journal of Geriatric Oncology
Miriam B Rodin
When considering screening for early cancer detection physicians should anticipate how they plan to follow up a screen detected cancer. Geriatric oncology research has developed validated functional assessments to estimate the balance of risk and benefit for treating cancers in the elderly. Robust elderly can benefit from treatment and therefore might benefit from screening. However the majority of elderly in long term residential care (LTC, or "the nursing home") would not benefit from cancer screening. The 1...
November 18, 2016: Journal of Geriatric Oncology
Lindsay L Peterson, Arti Hurria, Tao Feng, Supriya G Mohile, Cynthia Owusu, Heidi D Klepin, Cary P Gross, Stuart M Lichtman, Ajeet Gajra, Ilya Glezerman, Vani Katheria, Laura Zavala, David D Smith, Can-Lan Sun, William P Tew
PURPOSE: To evaluate the association between renal function (RF) and chemotherapy-related toxicity (CRT) in older adults with cancer and to compare the effect of different RF formulas and body weight measurements on this association. METHODS: This is a secondary analysis of data from a prospective multicenter study of patients ≥ age 65 who were starting a new chemotherapy regimen. RF was estimated with 4 formulas (modified Jelliffe [Jelliffe], Cockcroft-Gault [CG], Wright, and Modification of Diet in Renal Disease [MDRD]), using actual, ideal and adjusted body weights for 492 patients...
November 14, 2016: Journal of Geriatric Oncology
Justin P Turner, Sepehr Shakib, J Simon Bell
"Is my older cancer patient on too many medications?" is a question that confronts many physicians. Increasing age is associated with an increase in comorbidity, and consequently an increase in the number of medications prescribed to provide symptomatic relief and prevent disease related sequelae. The use of multiple medications, often termed polypharmacy, is highly prevalent in older people with cancer. Polypharmacy is not necessarily inappropriate but has been associated with drug-drug interactions, use of potentially inappropriate medications and a range of adverse events...
November 10, 2016: Journal of Geriatric Oncology
Matti Aapro, Carsten Bokemeyer, Heinz Ludwig, Pere Gascón, Mario Boccadoro, Kris Denhaerynck, Michael Gorray, Andriy Krendyukov, Karen MacDonald, Ivo Abraham
BACKGROUND: Myelotoxic chemotherapy is associated with chemotherapy-induced (febrile) neutropenia (CIN/FN). The MONITOR-GCSF study evaluated biosimilar filgrastim (Zarzio®) prophylaxis patterns, associated outcomes, and determinants. We performed stratified analyses comparing elderly and non-elderly patients. METHODS: Comparative (elderly/non-elderly) analysis of demographics and clinical status, prophylaxis, associated CIN/FN outcomes (CIN grade 4 [CIN4], FN, CIN/FN-related hospitalizations and chemodisturbances, composite), and, per hierarchical modeling, determinants thereof evaluated at the patient- and cycle-level...
November 6, 2016: Journal of Geriatric Oncology
Shabbir M H Alibhai, Salman Aziz, Tharsika Manokumar, Narhari Timilshina, Henriette Breunis
OBJECTIVE: Since the benefits of chemotherapy in treating older men with metastatic castration-resistant prostate cancer (mCRPC) are modest, validated tools that predict the risk of treatment toxicity may aid clinical decision-making. Whether these tools are better than oncologist judgment remains unclear. We compared the Cancer and Aging Research Group (CARG) tool, the Vulnerable Elders Survey-13 (VES-13), and oncologist judgment in predicting toxicity in men with mCRPC undergoing chemotherapy...
October 15, 2016: Journal of Geriatric Oncology
Martine Extermann, Christiaan Leeuwenburgh, Laila Samiian, Marina Sehovic, Jinze Xu, Christopher Cubitt, Paul B Jacobsen, Marco Pahor, Stephen R Grobmyer, Todd M Manini
OBJECTIVE: Chemotherapy is less often prescribed in older individuals due to concerns about post-treatment morbidity and quality of life. We evaluated the physical performance of breast cancer survivors treated with and without adjuvant chemotherapy. MATERIALS AND METHODS: We conducted a case-control study in 56 estrogen receptor positive breast cancer survivors (BCS) on adjuvant aromatase inhibitors 1-2years after definitive surgery. Cases had received adjuvant chemotherapy (n=27; age 70...
October 13, 2016: Journal of Geriatric Oncology
Tobin J Strom, Arash O Naghavi, Andy M Trotti, Jeffery Russell, Julie A Kish, Judith McCaffrey, Kristen J Otto, Louis B Harrison, Jimmy J Caudell
PURPOSE: Concurrent chemoradiotherapy (CRT) is the standard of care for many sites of locally advanced head and neck squamous cell carcinomas (LAHNC). However, on meta-analysis, the addition of chemotherapy did not improve survival for patients >70years. We hypothesized that elderly patients treated with CRT would have increased toxicity without similar improvements in survival. METHODS: A single-institution, IRB-approved retrospective study took place from 2005 to 2012 including 369 patients treated with CRT for LAHNC...
October 3, 2016: Journal of Geriatric Oncology
Lieke G E M Razenberg, Felice N van Erning, Hans F M Pruijt, Albert J Ten Tije, Johanna M G H van Riel, Geert-Jan Creemers, Valery E P P Lemmens
OBJECTIVES: The paucity of evidence for the optimal use of systemic therapy in elderly patients with metastatic colorectal cancer (mCRC) poses significant challenges to cancer specialists. The present population-based study provides insight into the impact of age on palliative systemic therapy in patients with metachronous metastases from CRC, in order to optimize the decision-making process. METHODS: Data on the development and treatment of metachronous metastases were collected for patients with primary resected CRC diagnosed between 2003 and 2008 in the Eindhoven area of the Netherlands Cancer Registry...
September 19, 2016: Journal of Geriatric Oncology
Sarah Schroyen, Manon Marquet, Guy Jerusalem, Benoît Dardenne, Marjan Van den Akker, Frank Buntinx, Stéphane Adam, Pierre Missotten
OBJECTIVES: Older people may suffer from stigmas linked to cancer and aging. Although some studies suggested that a negative view of cancer may increase the level of depression, such an association has never been studied in the elderly population. Similarly, even though it is established that a negative self-perception of aging has deleterious consequences on mental and physical health in normal aging, the influence in pathological contexts, such as oncology, has not been studied. The main aim of this study is thus to analyze the effect of these two stigmas on the health of elderly oncology patients...
September 19, 2016: Journal of Geriatric Oncology
Christopher B Steer, Etienne G C Brain
No abstract text is available yet for this article.
September 2016: Journal of Geriatric Oncology
Tina Hsu
The population is aging accounting for a large increase in anticipated cancer cases. Specialty training for trainees interested in geriatric oncology have been established in many countries and is growing globally. However, the number of clinicians with a particular interest in geriatric oncology and who complete training in both specialties is low. There are insufficient geriatric oncologists and geriatricians to address the unique needs of this population of patients. The majority of older adults with cancer are, and will continue to be, treated by oncologists...
September 2016: Journal of Geriatric Oncology
Nicolas Kint, Michel Delforge
In the last decades, treatment of multiple myeloma (MM) has greatly improved due to the introduction of novel agents, including proteasome inhibitors (PI) and immunomodulatory agents (IMiDs). Given their generalized use at diagnosis and at relapse and their proven benefit for the large cohort of MM patients, it is of pivotal importance to also critically evaluate any benefit of these agents in very elderly (>75years) and frail patients. This review gives an overview of the benefits and toxicities of the currently available treatments in very elderly MM patients with a focus on first-line treatment...
September 2016: Journal of Geriatric Oncology
William P Tew
Ovarian cancer is the seventh most common cancer in women worldwide and accounts for nearly 4% of all new cases of cancer in women. Almost half of all patients with ovarian cancer are over the age of 65 at diagnosis, and over 70% of deaths from ovarian cancer occur in this same age group. As the population ages, the number of older women with ovarian cancer is increasing. Compared to younger women, older women with ovarian cancer receive less surgery and chemotherapy, develop worse toxicity, and have poorer outcomes...
September 2016: Journal of Geriatric Oncology
Manvi Sharma, Kah Poh Loh, Ginah Nightingale, Supriya G Mohile, Holly M Holmes
Polypharmacy is a highly prevalent problem in older persons, and is challenging to assess and improve due to variations in definitions of the problem and the heterogeneous methods of medication review and reduction. The purpose of this review is to summarize evidence regarding the prevalence and impact of polypharmacy in geriatric oncology patients and to provide recommendations for assessment and management. Polypharmacy has somewhat variably been incorporated into geriatric assessment studies in geriatric oncology, and polypharmacy has not been consistently evaluated as a predictor of negative outcomes in patients with cancer...
September 2016: Journal of Geriatric Oncology
Theodora Karnakis, Isabella F Gattás-Vernaglia, Marcos Daniel Saraiva, Luiz Antônio Gil-Junior, Ana Lumi Kanaji, Wilson Jacob-Filho
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 significant resources. The challenges of MDTs must be known so that better care planning for elderly patients with cancer can be devised. The aim of this paper is to discuss the practical aspects of the multidisciplinary care of older adults with cancer by considering a geriatric point of view and the recent literature...
September 2016: Journal of Geriatric Oncology
Barbara Eichhorst, Michael Hallek, Valentin Goede
The majority of patients with chronic lymphocytic leukemia (CLL) are over 70years old. These patients vary in their vulnerability toward treatment efforts. Heterogeneity in fitness of older patients with CLL is mainly determined by individual differences in physiological aging and pathological conditions such as comorbidities and geriatric syndromes. Various options exist to treat older patients with CLL outside and inside clinical trials. Among these are new treatment approaches, including chemoimmunotherapy with engineered CD20 antibodies (e...
September 2016: Journal of Geriatric Oncology
Katherine W Armstrong, Carlos E Bravo-Iñiguez, Francine L Jacobson, Michael T Jaklitsch
Surgical research concentrating on cancer in the elderly has changed from small single institution outcome studies of carefully selected patients to larger studies that test specific aspects of surgical selection, treatment, and outcome. The purpose of this paper is to review major new trends in surgical geriatric oncology research within the last decade. Reviewing PubMed listings of the last 10years reveals several identifiable areas of particular concentration. Although we use specific studies primarily from lung cancer treatment, the generalizations can be seen across the spectrum of geriatric cancers...
September 2016: Journal of Geriatric Oncology
Ronald J Maggiore
Multidisciplinary, team-based care goes hand in hand with geriatric oncology paradigms for caring for older adults with cancer. Team-based care was the central theme for the 2015 SIOG Annual Meeting. Team-based approaches to the evaluation and management of older adults with different cancer types, including head and neck cancer, were presented. This review aims to summarize the salient points of that presentation, including a synthesis of recent multidisciplinary, "gero-centric" research efforts to improve the care for older adults with more advanced stages of head and neck cancer...
September 2016: Journal of Geriatric Oncology
Carole Helissey, Cécile Vicier, Stéphane Champiat
Monoclonal antibodies targeting immune checkpoint molecules CTLA-4, PD-1 or PD-L1 are emerging as promising anticancer therapeutics in multiple cancer subtypes resulting in remarkable and long-lasting clinical responses. These immune checkpoint blockers (ICBs) have already obtained approval for the treatment of patients with metastatic melanoma, advanced/refractory non-small cell lung cancer and renal cell cancer. ICBs enhance immune responses against cancer cells but can also lead to inflammatory side effects called immune-related adverse events (irAEs)...
September 2016: Journal of Geriatric Oncology
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