Journal of geriatric oncology最新文献

{"title":"Graft versus host disease treatment and prevention in older adults: A single-database review","authors":"William Ciurylo ,&nbsp;Anahid Hamparsumian ,&nbsp;Sarah Wall ,&nbsp;Gabrielle Meyers","doi":"10.1016/j.jgo.2026.102848","DOIUrl":"10.1016/j.jgo.2026.102848","url":null,"abstract":"<div><h3>Introduction</h3><div>Hematopoietic stem cell transplantation (SCT) is increasingly used to treat hematological conditions in patients 60 years and older. Graft vs host disease (GVHD), a complication of SCT, is a major cause of morbidity, nonrelapse mortality, and interference with quality of life (QOL). Concern that older adults are at higher risk for developing GVHD has limited the use of SCT in this population. Older adults are also at higher risk for adverse events from the mainstay treatment of GVHD: corticosteroids. There is no standard of care for the management of GVHD in older adults, which may limit older adults' access to SCT. We aimed to review the literature on non-corticosteroid immune modulating agents used to prevent and treat GVHD for outcomes data specific to older adults.</div></div><div><h3>Materials and methods</h3><div>We performed a scoping review using Pubmed, identifying 31 studies comparing immunosuppressive prophylaxis and treatment modalities for GVHD (acute, chronic, mixed, and corticosteroid refractory) within a 10-year span (February 13, 2013 - February 13, 2023). Articles exploring cutaneous GVHD only or corticosteroid treatments were excluded. Articles were reviewed for inclusion of patients 65+ years, response rate, mortality rate, adverse events, degree of corticosteroid sparing, and QOL scores before and after treatment.</div></div><div><h3>Results</h3><div>Seventeen articles met inclusion criteria, for a total of 2534 patients with GVHD. Two articles did not include patients 65+, ten did not specify the number of patients 65+, and five articles indicated the number of patients 65+ (<em>n</em> = 160). No articles specified response rate, mortality rate, or adverse events in patients 65+. Twelve articles indicated degree of corticosteroid sparing. Six articles included QOL scores, but did not assess impact of treatment on QOL scores or specify QOL scores in patients 65+. Overall, 3.5% of study participants were identified as aged 65+ and 4.7% aged 60 + .</div></div><div><h3>Discussion</h3><div>There is a lack of relevant outcomes data to guide best practice in the prevention and treatment of GVHD in older adults Understanding the risk of GVHD in older adults and identifying effective prophylactic and treatment strategies for GVHD in older adults may result in more older adults having access to SCT.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102848"},"PeriodicalIF":2.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding the sweet spot between standardisation and tailoring, using the implementation science principles in oncogeriatrics","authors":"Jorge Browne ,&nbsp;Verónica Araya ,&nbsp;Natalie Pinto ,&nbsp;Estefany Quintana ,&nbsp;Ignacio Salazar ,&nbsp;Bruno Nervi ,&nbsp;Benjamin Walbaum","doi":"10.1016/j.jgo.2026.102849","DOIUrl":"10.1016/j.jgo.2026.102849","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102849"},"PeriodicalIF":2.7,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerability of docetaxel in octogenarians with metastatic prostate cancer in the triplet therapy era: A single-center retrospective cohort study","authors":"Kimitsugu Usui,&nbsp;Atsuto Suzuki,&nbsp;Hayato Kubo,&nbsp;Takahiro Matsumoto,&nbsp;Tomohiko Aigase,&nbsp;Takeshi Kishida,&nbsp;Noboru Nakaigawa","doi":"10.1016/j.jgo.2025.102844","DOIUrl":"10.1016/j.jgo.2025.102844","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102844"},"PeriodicalIF":2.7,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145837494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of current best practice in radiation oncology for older adults with cancer: Updates from the International Society of Geriatric Oncology (SIOG) Task Force","authors":"Lucinda Morris ,&nbsp;Niluja Thiruthaneeswaran ,&nbsp;Anita O'Donovan ,&nbsp;Noam VanderWalde ,&nbsp;Anthea Cree ,&nbsp;Surbhi Grover ,&nbsp;Stefan Starup Jeppesen ,&nbsp;Richard Simcock","doi":"10.1016/j.jgo.2025.102839","DOIUrl":"10.1016/j.jgo.2025.102839","url":null,"abstract":"<div><div>Radiotherapy (RT) is a vital and effective cancer treatment that contributes to over 40 % of cancer cures. RT is also fundamental to palliation and improving quality of life in almost all advanced malignancies. The specialty of radiation oncology has undergone dramatic technological advances over the past decade with increasing sophistication of treatment planning and delivery leading to improved cure rates and reduced side effects. For older adults with cancer, RT represents an excellent treatment option due to its effectiveness, limited systemic toxicity, convenience, and tolerability. Advanced techniques such as stereotactic body radiotherapy (SBRT) and hypofractionated regimens are highly effective non-invasive treatment options that may avoid the need for hospital admission, the potential mortality and morbidity of surgery and/or the toxicities of systemic therapy. Historically, the role of RT for older adults has not been comprehensively assessed or defined due to the limited recruitment of older adults to clinical trials. Fortunately, the increasing number of RT trials tailored to specifically explore outcomes for older people is expanding the body of evidence for this priority research area.</div><div>This updated expert position paper from the SIOG (International Society of Geriatric Oncology) Task Force seeks to provide an overview of the current role of RT in the management of older adults with cancer. The position paper is informed by the geriatric radiation oncology clinical expertise of the SIOG Task Force and emerging evidence in the field since the publication of the original 2014 position paper. Topics covered include the fundamentals of geriatric oncology as applied to radiation oncology, options for dose fractionation schedules and techniques across pre-defined tumor sites and appropriate individualised modifications of regimens in the setting of frailty, discussion of expected tolerability and toxicity (if any) in older adults, and the unique perspectives of care around older adults requiring RT in low- and middle-income countries.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102839"},"PeriodicalIF":2.7,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of surgically resectable colorectal liver metastases in older patients","authors":"Sara Myers ,&nbsp;Ponnandai Somasundar ,&nbsp;Clark DuMontier ,&nbsp;Dae Hyun Kim ,&nbsp;Steve Kwon","doi":"10.1016/j.jgo.2025.102840","DOIUrl":"10.1016/j.jgo.2025.102840","url":null,"abstract":"<div><div>Surgical resection offers a curative treatment option for patients with colorectal cancer liver metastases (CRLM), but data on resection of CRLM among older patients is conflicting and sparse. The older population is heterogenous, and no age-calibrated guidelines for management of surgically resectable CRLM exist. Age-related physiologic changes to the liver include impaired tissue growth, increased oxidative stress and inflammation, and dysregulated metabolic homeostasis. Cumulatively, these changes to the liver microenvironment lead to decreased regeneration ability of the liver and higher vulnerability to the stress of surgery. Systemic chemotherapy may also be associated with worse hepatotoxicity among older patients. Given the combination of age-related physiological changes and chemotherapy-associated hepatotoxicity, evaluating both the volume and the function of the future liver remnant (FLR) among older patients is critically important. Additionally, older patients may have higher risks for both medical and surgical postoperative complications including following CRLM resection. Liver-directed therapy, including transarterial chemoembolization (TACE), transarterial delivery of irinotecan-coated beads (DEBIRI), hepatic infusion chemotherapy (HAI), as well as radiation and ablation therapy are well-tolerated and may be offered to older patients. Discussions of CRLM resection and treatment options should be paired with goals of care conversations for older patients, including wishes surrounding both quantity and quality of life, and functional outcomes. Some older patients, including frail individuals or those with limited life expectancies, may benefit more from liver-directed therapy than from surgical management of CRLM. Shared-decision making tools may be helpful for discussing potential post-operative issues with older patients, including quality-adjusted life expectancy, the potential for loss of independent living, and stays in long-term care facilities following CRLM resection in addition to morbidity and mortality.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102840"},"PeriodicalIF":2.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of hospital volume on mortality in adult women over 65 with triple-negative breast cancer","authors":"Barnabas T. Obeng-Gyasi ,&nbsp;Demond L. Handley ,&nbsp;Mohamed I. Elsaid ,&nbsp;Eric Schupp ,&nbsp;Daniel G. Stover ,&nbsp;J.C. Chen ,&nbsp;Jesus D. Anampa ,&nbsp;Xiaoyi Teng ,&nbsp;Samilia Obeng-Gyasi","doi":"10.1016/j.jgo.2025.102845","DOIUrl":"10.1016/j.jgo.2025.102845","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults (≥65 years) with triple-negative breast cancer (TNBC) have higher mortality rates than younger patients, due in part to greater comorbidity and lower rates of treatment. However, the impact of hospital volume on survival outcomes in this population remains understudied. This study examined the relationship between hospital volume and survival among older adults (aged 65 years or older) diagnosed with TNBC.</div></div><div><h3>Materials and methods</h3><div>The National Cancer Database was queried for women ages ≥65 years with stage I–III TNBC diagnosed between 2010 and 2020. Annual hospital volume was the facility-level average of breast cancer cases treated in the years before the year of diagnosis. Volumes were divided into quartiles, with the lowest quartile (≤136 cases/year) defined as low-volume and the remaining three quartiles combined as high-volume. Sociodemographic, clinical, and treatment characteristics were compared according to hospital volume status. Crude and adjusted mortality risk differences and relative risks were estimated using pooled logistic regression models.</div></div><div><h3>Results</h3><div>The study cohort comprised 37,538 older women with TNBC, of whom 25 % (<em>n</em> = 9388) were treated at low-volume hospitals. Patients treated at low-volume hospitals were slightly older (73 years [IQR: 68 to 79] vs. 72 years [IQR: 68 to 78 years]) and traveled a shorter distance to the hospitals (6.80 miles [IQR: 3.00 to 14.30] vs 8.60 miles [IQR: 4.30 to 18.00]) than those treated at high-volume hospitals (<em>p</em> &lt; 0.001). On adjusted analysis, treatment at low-volume hospitals (Low-Value Risk: 0.607, 95 % CI: 0.579 to 0.638) was associated with a 5.5 % increased risk of all-cause mortality compared to treatment at high-volume hospitals (High-Volume Risk: 0.576, 95 % CI: 0.556 to 0.592) (RR: 1.055, 95 % CI: 1.003 to 1.121). Patients treated at low-volume hospitals had a 3.2 % excess adjusted risk of mortality compared to those treated at higher-volume hospitals (RD: 3.2 %, 95 % CI: 0.2 % to 6.9 %).</div></div><div><h3>Discussion</h3><div>Older adults treated at low-volume hospitals had modestly higher mortality than those at high-volume facilities. Future work should identify mechanisms underlying this relationship and assess whether referral patterns for older adults should consider hospital volume.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102845"},"PeriodicalIF":2.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an older adult-centred cancer program at an academic centre in Ontario, Canada: Initial steps and early successes","authors":"Taleen Haddad ,&nbsp;Karen Misquitta ,&nbsp;Shaila J. Merchant","doi":"10.1016/j.jgo.2025.102838","DOIUrl":"10.1016/j.jgo.2025.102838","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102838"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of knowledge, perceptions of care, and current practice of geriatric surgical care at a dedicated cancer center: A survey study","authors":"Amalia J. Stefanou ,&nbsp;Betzaira Childers ,&nbsp;Diana L. Castillo ,&nbsp;Heather Freeman ,&nbsp;Alice Yu ,&nbsp;Mohammad Al-Jumayli ,&nbsp;Martine Extermann ,&nbsp;Daniel A. Anaya","doi":"10.1016/j.jgo.2025.102836","DOIUrl":"10.1016/j.jgo.2025.102836","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102836"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival prediction in older women with stage I-II breast cancer using decision tree-based machine learning","authors":"Hyuna Yoon ,&nbsp;Yeijin Kim ,&nbsp;Sola Han ,&nbsp;Hae Sun Suh ,&nbsp;Chanhyun Park","doi":"10.1016/j.jgo.2025.102828","DOIUrl":"10.1016/j.jgo.2025.102828","url":null,"abstract":"<div><h3>Introduction</h3><div>Predicting survival in older women with early breast cancer can guide personalized care and improve outcomes. Aging is an individualized process that influences tumor characteristics and survival, with cardiovascular disease (CVD) being the leading non-cancer cause of death due to cardiovascular risk factors. This study aimed to develop and validate machine learning (ML) models to predict all-cause, breast cancer-related, and CVD-related mortality in older women with stage I-II, hormone receptor-positive breast cancer at the U.S. population level. To address the heterogeneity associated with aging, we created separate models for two age groups (66–79 and ≥ 80 years).</div></div><div><h3>Materials and methods</h3><div>Using the 2006–2019 SEER–Medicare database, we identified women aged ≥66 years diagnosed with stage I–II breast cancer, representing early-stage invasive disease, who initiated adjuvant endocrine therapy (AET) between 2007 and 2009. The first date of AET use was defined as the index date. We assessed pre-existing comorbidities during the one year prior to the index date and followed patients for up to 10 years or until death. Outcomes included all-cause mortality, breast cancer-related mortality, and CVD-related mortality. We developed survival prediction models using the decision tree-based algorithms for the two age groups. Model performance was evaluated using the mean area under the receiver operating characteristic curve (AUROC), and model interpretability was enhanced using Shapley Additive Explanations.</div></div><div><h3>Results</h3><div>Among 10,104 women, all six models achieved a mean AUROC &gt;0.7 using the random survival forest algorithm (RSF), indicating strong predictive performance. For all-cause mortality, key predictors in both age groups included age, screenings for suspected conditions (abnormal findings without diagnosis), and congestive heart failure. Tumor size, cancer stage, and secondary malignancies were most predictive of breast cancer-related mortality, while congestive heart failure, heart valve disorders, and other ill-defined heart diseases were critical for CVD-related mortality.</div></div><div><h3>Discussion</h3><div>We developed ML-based survival models across outcomes and age group using the decision tree-based algorithms to predict mortality in older women with stage I-II breast cancer. RSF demonstrated the best performance, with age, screenings for suspected conditions, and congestive heart failure consistently emerging as key predictors. Targeting these factors may enhance cardio-oncology care.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102828"},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerability of immune checkpoint inhibitors for cancer treatment in frail, older patients","authors":"Rochelle Sheppard ,&nbsp;Christopher Anstey ,&nbsp;Leila Hanjani ,&nbsp;Rahul Ladwa ,&nbsp;Robin Berry ,&nbsp;James Fletcher ,&nbsp;Ruth Hubbard","doi":"10.1016/j.jgo.2025.102829","DOIUrl":"10.1016/j.jgo.2025.102829","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICIs) are increasingly used in older adults, but tolerability among frail patients remains uncertain. This study examined immune-related adverse events (irAEs) and treatment outcomes in frail and non-frail adults aged ≥65 years.</div></div><div><h3>Materials and methods</h3><div>A retrospective single-centre review was conducted at Princess Alexandra Hospital (Queensland, Australia) of patients aged ≥65 who commenced at least one cycle of ICI between December 2021 and July 2023. Frailty was assessed using the Australian 58-item Frailty Index (FI) (non-frail &lt;0.25, frail ≥0.25). The primary outcome was any irAE as defined by Common Terminology Criteria for Adverse Events (CTCAE v5). Secondary outcomes included treatment discontinuation, cycles, interruptions, and corticosteroid use. Univariable and multivariable logistic regression modelling was performed, adjusting for age, sex, cycles, tumour type, stage, concurrent therapy, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS).</div></div><div><h3>Results</h3><div>Of 122 adults (mean age 75.8 years, 66.4 % male), 51 (41.8 %) were frail. Twenty patients were still receiving ICIs and had not yet completed treatment at last census, leaving 102 records with evaluable outcomes for the final modelling. Any irAE occurred in 53 non-frail adults (74.7 %) and 28 frail adults (54.9 %) (adjusted OR 0.41, 95 % CI 0.19–0.89, <em>p</em> = 0.02). Non-frail adults had more grade 1 events (62.0 % vs 43.1 %, <em>p</em> = 0.045) and skin-related events (48 % vs 27 %, p = 0.04). Grade ≥ 3 events occurred in 11.3 % non-frail vs 11.8 % frail (OR 1.10, 95 % CI 0.38–3.17). Early discontinuation was 60.6 % in non-frail vs 74.5 % in frail (OR 1.90, 95 % CI 0.86–4.19, <em>p</em> = 0.12). Median cycles were 10 (IQR 4–16) in non-frail vs 6 (IQR 4–11) in frail (<em>p</em> = 0.04).</div></div><div><h3>Discussion</h3><div>Frailty (FI ≥0.25) was associated with fewer irAEs, but frail adults received fewer cycles. These findings are exploratory and should be interpreted cautiously as differences in exposure likely confound toxicity comparisons; time-to-event analyses are warranted.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102829"},"PeriodicalIF":2.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}