Clin-STAR Corner: Practice Changing Advances at the Interface of Oncology and Geriatrics.

Tanyanika Phillips, Jingran Ji, Vani Katheria, William Dale
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Abstract

Cancer and aging are inextricably linked, and older adults are a significant proportion of those diagnosed, treated, and living with and beyond a cancer diagnosis. Several large prospective studies have enhanced our understanding of how to improve the assessment, treatment, and outcomes of older adults with cancer starting therapy. This article summarizes three recent high-impact trials that produced practice-changing implications for the management of older adults with cancer that led to guideline updates. The key findings from these trials highlight that geriatric assessment-guided interventions in older adults with cancer: (1) facilitated higher rates of chemotherapy completion at planned doses with less modification among patients, (2) reduced grade 3 hematologic and non-hematologic toxicity during treatment delivery among patients of all stages of cancer receiving chemotherapy, and (3) influenced treatment decisions among advanced cancer patients receiving supportive care leading to reduced toxicity through reduced intensity of therapy without compromise of survival.

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clini - star角:肿瘤学和老年病学界面的实践变化进展。
癌症和衰老有着千丝万缕的联系,老年人在被诊断、接受治疗的癌症患者中占很大比例。几项大型前瞻性研究增强了我们对如何改善老年人癌症开始治疗的评估、治疗和结果的理解。这篇文章总结了最近三个高影响的试验,这些试验对老年癌症患者的管理产生了改变实践的影响,并导致了指南的更新。这些试验的主要发现强调,以老年评估为指导的老年癌症干预措施:(1)促进了患者在计划剂量下更高的化疗完成率,减少了化疗的修改;(2)降低了接受化疗的所有阶段癌症患者在治疗过程中的3级血液学和非血液学毒性;(3)影响了接受支持性治疗的晚期癌症患者的治疗决策,通过降低治疗强度降低毒性,而不影响生存。
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Application of an Electronic Frailty Index to Identify High-Risk Older Adults Using Electronic Health Record Data. Cancer and Accelerated Aging Research at the National Institutes of Health, 2013-2023: A Grant Portfolio Analysis. Home-Based Comprehensive Geriatric Assessment for Community-Dwelling, At-Risk, Frail Older Adults: A Systematic Review and Meta-Analysis. Individualized Net Benefit of Intensive Blood Pressure Lowering Among Community-Dwelling Older Adults in SPRINT. Inspiring Undergraduate Student Training in Alzheimer's Research (USTAR): Training the Next Generation of Aging Scientists.
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