Journal of geriatric oncology最新文献

英文中文

Association of age and performance status with adverse events in older adults with diffuse large B-cell lymphoma receiving frontline R-CHOP therapy: Alliance 151930, a secondary analysis of the phase III trial CALGB 50303 年龄和体能状况与接受一线R-CHOP治疗的老年弥漫性大b细胞淋巴瘤不良事件的关联：Alliance 151930， III期试验CALGB 50303的二次分析。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-13 DOI: 10.1016/j.jgo.2025.102185

Vicki A. Morrison , Jennifer Le-Rademacher , Olivia Bobek , Daniel Satele , John P. Leonard , Aminah Jatoi

Introduction

Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) therapy is the standard of care for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). However, detailed delineation of toxicity data is limited and has not been examined by age. We sought to examine adverse event data in patients receiving R-CHOP from the Cancer and Leukemia Group B (CALGB) 50303 trial to determine if there were differences in grade 3+ toxicities by age cohort or ECOG performance status (PS), and if outcome was impacted by age cohort or toxicity occurrence.

Materials and Methods

CALGB 50303 was an intergroup phase III study for previously untreated patients with DLBCL that included R-CHOP as one of the trial arms. In the subset of 235 evaluable, seemingly fit patients receiving R-CHOP on this trial, data regarding the occurrence of grade 3+ hematologic and non-hematologic toxicities by treatment arm, as well as completion of protocol therapy, overall response rate (ORR), and survival outcome parameters were collected and analyzed for Alliance A151930.

Results

Data were available for further analysis from 235 of 243 patients evaluable for safety, i.e., those who received R-CHOP therapy on this trial, with 165 being <65 years of age, and 70 ≥ 65 years of age. There was an increased rate of grade 3+ non-hematologic (but not hematologic) toxicities in the older age cohorts, after controlling for disease stage and performance status (p < 0.001). One-year and three-year overall survival (OS) were inferior in patients ≥65 years of age, compared to those <65 years of age; there was no difference in one-year or in three-year progression-free survival (PFS) between the age cohorts.

Discussion

Standard frontline therapy with R-CHOP can be effectively administered to an older age cohort. We found more grade 3+ non-hematologic, but not hematologic, toxicities in older patients. These data can be used in clinical trial and real-world settings to identify at-risk DLBCL subgroups for which pro-active measures can be utilized to ensure completion of therapy and optimization of clinical outcomes.

Clinicaltrials.gov Identifier: NCT00118209 (CALGB 50303).

利妥昔单抗、环磷酰胺、阿霉素、长春新碱、强的松（R-CHOP）治疗是新诊断的弥漫性大b细胞淋巴瘤（DLBCL）患者的标准治疗方案。然而，毒性数据的详细描述是有限的，并且没有按年龄进行检查。我们试图检查来自癌症和白血病B组（CALGB） 50303试验中接受R-CHOP的患者的不良事件数据，以确定年龄队列或ECOG表现状态（PS）是否存在3级以上毒性的差异，以及结果是否受到年龄队列或毒性发生的影响。材料和方法：CALGB 50303是一项针对未经治疗的DLBCL患者的组间III期研究，其中包括R-CHOP作为试验组之一。在该试验中，235名可评估的、似乎适合接受R-CHOP治疗的患者中，收集并分析了联盟A151930治疗组3+级血液学和非血液学毒性的发生数据，以及方案治疗的完成情况、总缓解率（ORR）和生存结局参数。结果：243例可评估安全性的患者中有235例（即在该试验中接受R-CHOP治疗的患者）的数据可用于进一步分析，其中165例正在讨论：标准一线治疗R-CHOP可有效地用于老年队列。我们在老年患者中发现更多的3+级非血液学毒性，而不是血液学毒性。这些数据可用于临床试验和现实环境，以确定有风险的DLBCL亚组，可采用主动措施确保完成治疗并优化临床结果。临床试验：gov标识号：NCT00118209 （CALGB 50303）。

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引用次数: 0

Relevance of diabetes mellitus as a confounding variable in chemotherapy outcomes 糖尿病作为化疗结果的混杂变量的相关性。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-13 DOI: 10.1016/j.jgo.2025.102188

Amir Reza Akbari , Benyamin Alam

引用次数: 0

Increasing the evidence for comprehensive geriatric assessment – Outlook on another work in progress 增加综合老年评估的证据——对另一项正在进行的工作的展望。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-12 DOI: 10.1016/j.jgo.2024.102078

Miriam Hüttmeyer , Kathrin Tatschner , Elisabeth Jentschke , Carmen Roch , Barbara Deschler-Baier

引用次数: 0

Exploring the status of online social support for older adults with cancer: A scoping review. 探讨老年癌症患者的在线社会支持状况：范围综述。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-09 DOI: 10.1016/j.jgo.2024.102182

Fei Liu, Sophie Pilleron, India Pinker

Introduction: The number of new cancer cases among older adults is rising, yet their social support needs remain unmet due to diminishing social networks with age. Since the COVID-19 pandemic, online technologies have provided increased opportunities for social support for this demographic via digital platforms such as online peer support groups, online communities, and chat rooms. This scoping review explores the current state of the use of online social support for older adults with cancer.

Materials and methods: This scoping review was based on the Arksey and O'Malley methodological framework with the extension proposed by Levac and colleagues. The protocol was registered on Open Science Framework (OSF). PubMed, Elsevier Embase (including Medline), and EBSCO CINAHL Complete were searched to identify eligible studies. The review findings were presented in a narrative synthesis.

Results: Out of 6542 references, we included three studies. Two studies investigated older patients' preferences for different types of peer support through surveys and questionnaires, and the third examined the feasibility of an online platform for older women with breast cancer. Barriers identified include a lower interest and familiarity, sense of involvement, and emotional impact of a new diagnosis. However, factors such as socio-demographic characteristics and positive motivation for using online peer support act as facilitators.

Discussion: This scoping review is the first to examine the literature on online social support specifically for older adults with cancer, revealing a paucity of research. Further research is required to understand the potential need and interest in online social support for this population, especially as technology becomes more integrated into daily life post-COVID.

导言：老年人中新发癌症病例的数量正在上升，但由于他们的社会网络随着年龄的增长而减少，他们的社会支持需求仍然没有得到满足。自2019冠状病毒病大流行以来，在线技术通过在线同伴支持小组、在线社区和聊天室等数字平台为这一人群提供了更多的社会支持机会。本综述探讨了老年癌症患者使用在线社会支持的现状。材料和方法：本综述以Arksey和O'Malley方法框架为基础，并由Levac及其同事提出扩展。该协议已在开放科学框架（OSF）上注册。检索PubMed、Elsevier Embase（包括Medline）和EBSCO CINAHL Complete以确定符合条件的研究。审查结果以叙述综合形式提出。结果：在6542篇文献中，我们纳入了3篇研究。两项研究通过调查和问卷调查调查了老年患者对不同类型同伴支持的偏好，第三项研究考察了为患有乳腺癌的老年妇女建立在线平台的可行性。确定的障碍包括兴趣和熟悉程度降低，参与感降低以及新诊断的情感影响。然而，诸如社会人口特征和使用在线同伴支持的积极动机等因素起着促进作用。讨论：这篇范围综述是第一个专门研究老年癌症患者在线社会支持的文献，揭示了研究的缺乏。需要进一步研究，以了解这一人群对在线社会支持的潜在需求和兴趣，特别是在技术更加融入日常生活的情况下。

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引用次数: 0

Three lessons from "The Fox and the Grapes" to inform precision oncology in the older adult. 《狐狸与葡萄》的三个教训为老年人的精确肿瘤学提供信息。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-09 DOI: 10.1016/j.jgo.2025.102186

Gabriel Aleixo, Teja Voruganti, Ramy Sedhom

引用次数: 0

Efficacy and safety of enfortumab vedotin in older patients with metastatic urothelial carcinoma: A multicenter retrospective study 老年转移性尿路上皮癌患者使用维多汀的疗效和安全性：一项多中心回顾性研究。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-09 DOI: 10.1016/j.jgo.2024.102183

Tetsuya Shindo , Kohei Hashimoto , Toshiki Kenuka , Shintaro Miyamoto , Yoshiki Hiyama , Fumimasa Fukuta , Yasuharu Kunishima , Manabu Okada , Masanori Matsukawa , Ryuichi Kato , Masaya Senda , Atsushi Wanifuchi , Shunsuke Sato , Ko Kobayashi , Toshiaki Tanaka , Naoya Masumori , on behalf of the Sapporo Medical University Urologic Oncology Consortium

Introduction

We aimed to evaluate the efficacy and safety of enfortumab vedotin therapy for a cohort of older Japanese patients with metastatic urothelial carcinoma compared to younger patients.

Materials and Methods

We retrospectively evaluated patients with metastatic urothelial carcinoma treated with enfortumab vedotin and recruited between April 2019 and February 2023. Older patients were defined as being ≥75 years old. Efficacy was evaluated by comparing overall survival, progression-free survival, and objective response rates between groups. Adverse events and relative dose intensity were also compared. Moreover, the prognostic factor for overall survival in the entire cohort was evaluated using multivariate analysis.

Results

Of the 57 patients treated with enfortumab vedotin, 37 were younger and 20 were older, (median ages of 67.6 and 79.2, respectively). Median overall survival in older and younger patients was 407 and 365 days, respectively (P = 0.48). The objective response rate was 60.0 % and 54 % (P = 0.68) and median progression-free survival 228 and 223 days in older and younger patients, respectively (P = 0.76). Adverse events were equivalent between groups except for liver dysfunction, which frequently occurred in younger patients. The dose intensity for the older and younger patients did not differ (65.7 % vs. 63.5 %, P = 0.37, respectively). In multivariate analysis, neutrophil-to-lymphocyte ratio of 3 or more was the only risk factor for worse overall survival in the entire cohort (P = 0.04).

Discussion

Our data demonstrated that enfortumab vedotin therapy can benefit older patients with metastatic urothelial carcinoma equivalent to younger patients without compromising safety profiles.

内容简介我们旨在评估与年轻患者相比，恩福单抗韦多汀治疗日本老年转移性尿路上皮癌患者队列的有效性和安全性：我们对2019年4月至2023年2月期间招募的接受恩福单抗维多汀治疗的转移性尿路上皮癌患者进行了回顾性评估。老年患者定义为年龄≥75岁。疗效通过比较组间总生存期、无进展生存期和客观反应率进行评估。同时还比较了不良反应和相对剂量强度。此外，还通过多变量分析评估了整个组群总生存期的预后因素：结果：在接受恩福单抗维多汀治疗的57名患者中，37名患者年龄较小，20名患者年龄较大（中位年龄分别为67.6岁和79.2岁）。老年患者和年轻患者的中位总生存期分别为407天和365天（P=0.48）。老年患者和年轻患者的客观反应率分别为 60.0% 和 54%（P = 0.68），无进展生存期中位数分别为 228 天和 223 天（P = 0.76）。除肝功能异常常发生于年轻患者外，其他不良反应在各组之间相当。老年患者和年轻患者的剂量强度没有差异（分别为 65.7% 和 63.5%，P = 0.37）。在多变量分析中，中性粒细胞与淋巴细胞比值大于或等于3是整个队列中总生存率降低的唯一风险因素（P = 0.04）：我们的数据表明，恩福单抗维多汀疗法可使老年转移性尿路上皮癌患者受益，其受益程度与年轻患者相当，且不影响安全性。

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引用次数: 0

From healthy aging to complex needs in older adults: Onco-geriatric insights from the EuGMS 2024 conference, a report from Young SIOG. 从健康老龄化到老年人的复杂需求：来自EuGMS 2024会议的肿瘤学见解，Young SIOG的一份报告。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-08 DOI: 10.1016/j.jgo.2024.102156

Filippo M Verri, Nicolás M González-Senac, Chloé Herledan, Frederiek van den Bos, Nina R Neuendorff

引用次数: 0

Adjuvant taxane-based chemotherapy treatment in older patients with early breast cancer: A pooled analysis of five phase III trials from the Hellenic Oncology Research Group 基于紫杉烷的辅助化疗治疗老年早期乳腺癌患者：来自希腊肿瘤研究小组的五项III期试验的汇总分析。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-08 DOI: 10.1016/j.jgo.2024.102184

Oraianthi Fiste, Lambros Vamvakas, Panagiotis Katsaounis, Nikolaos Vardakis, Sofia Kallianteri, Vassilis Georgoulias, Athanasios Karampeazis

Introduction

The use of taxanes in the adjuvant setting of early breast cancer (BC) confers survival benefits, however, their role in older patients merits further study. This retrospective pooled analysis of randomized controlled trials conducted by the Hellenic Oncology Research Group (HORG) aims to assess the efficacy and safety of taxane-based adjuvant chemotherapy in older women with BC.

Materials and Methods

Five phase III trials containing a taxane, conducted by HORG between 1995 and 2013, were included in a patient-data pooled analysis. The primary endpoint was disease-free survival (DFS) at three years, whereas secondary outcomes included overall survival (OS) at five years and toxicity.

Results

A total of 3,026 randomized patients, of whom 701 (23 %) were ≥ 65 years old (median age 69 years; range 65–80), were included in the analysis. No statistically significant heterogeneity in survival was observed between older and younger patients. Within the cohort of older patients, taxane-based regimens were superior to 5-fluorouracil, epirubicin, and cyclophosphamide (FE₇₅C) regimen in terms of three-year DFS (92.02 % vs 77.17 %; p < 0.001) and five-year OS (94.38 % vs 72.64 %; p < 0.001), respectively. A higher number of older patients discontinued treatment compared to younger patients (5.7 % vs 2.9 %; p < 0.001), mainly due to toxicity (3.4 % vs 1.8 %; p = 0.01). The incidence of grade 3–4 neutropenia (35.4 % vs 29.8 %; p = 0.006) and thrombocytopenia (0.8 % vs 0.3 %; p = 0.049) was higher for patients aged ≥65 years compared to those aged <65 years; however, there was no difference in terms of febrile neutropenia and non-hematologic toxicity.

Discussion

Taxane-based adjuvant chemotherapy offers significant survival benefits in older patients with BC, similar to younger patients, yet with increased toxicity.

在早期乳腺癌（BC）的辅助治疗中使用紫杉烷类药物可以提高生存率，然而，它们在老年患者中的作用值得进一步研究。这项由希腊肿瘤研究小组（HORG）进行的随机对照试验的回顾性汇总分析旨在评估紫杉烷为基础的辅助化疗对老年女性BC的疗效和安全性。材料和方法：1995年至2013年期间，HORG进行了5项含有紫杉烷的III期试验，纳入患者数据汇总分析。主要终点是3年无病生存期（DFS），而次要终点包括5年总生存期（OS）和毒性。结果：共有3026例随机患者，其中701例（23%）年龄≥65岁(中位年龄69岁；范围65-80)，被纳入分析。在老年和年轻患者之间，生存率没有统计学上显著的异质性。在老年患者队列中，紫杉烷为基础的方案在3年DFS方面优于5-氟尿嘧啶、表柔比星和环磷酰胺（FE75C）方案(92.02% vs 77.17%；讨论：紫杉烷为基础的辅助化疗为老年BC患者提供了显著的生存益处，与年轻患者相似，但毒性增加。

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引用次数: 0

Geriatric Assessment-driven INterventions among Hospitalized older adults with cancer (GAIN-HOSP), a prospective pilot study 一项前瞻性试点研究--"老年病学评估驱动的住院老年癌症患者干预"（GAIN-HOSP）。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-01 DOI: 10.1016/j.jgo.2024.102063

Leana Cabrera Chien, Can-Lan Sun, Heeyoung Kim, Carolina Uranga, Enrique Soto-Perez-de-Celis, Peggy Burhenn, Kemeberly Charles, Jessica Vazquez, Elsa Roberts, Wai Yu (Kim), Jae Y. Kim, Clayton Lau, Stephen Sentovich, Tanya B. Dorff, Mina S. Sedrak, Vani Katheria, Arti Hurria, William Dale, Daneng Li

引用次数: 0

The care of older patients with cancer across the United Kingdom in 2024: A narrative review by the International Society of Geriatric Oncology UK Country Group 2024 年英国对老年癌症患者的护理：国际老年肿瘤学会英国国家小组的叙述性审查。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology

Pub Date : 2025-01-01 DOI: 10.1016/j.jgo.2024.102133

Fabio Gomes , Naomi Farrington , Jessica Pearce , Daniel Swinson , Jenny Welford , Alastair Greystoke , Mark Baxter , Alana G. Brown-Kerr , Lynda Wyld , Jenna Morgan , Nicolò Matteo Luca Battisti , Anne Barrell , David Cobben , Anthea Cree , Mark Johnston , Kirsty Colquhoun , Iain Phillips , Jemima Smith , Simon Stapley , Lisa Lyons , Kwok-Leung Cheung

The worldwide population is ageing, alongside an increase in cancer incidence rates. Over the past 10 years, there has been huge progress in the field of oncology with earlier diagnosis and an expansion of treatment options, leading to a growing number of older people living with cancer. That has meant that caring for older patients with cancer is now part of day-to-day oncology practices. This cohort often has geriatric syndromes and a higher prevalence of frailty and complex needs and preparing our clinical services to optimise care for these patients is essential. Whilst it is widely accepted that comprehensive geriatric assessments are of benefit to patients, only a small proportion of patients can access these through specialised teams during their cancer care. In the past few years there has been significant progress in this field throughout the United Kingdom (UK). The goal of this review is to inform other health care systems how to learn from what has been done in the UK. This paper provides an update from our previous review in 2020, detailing the new services being implemented and made available to patients and an expansion in the number of new pilot teams and research projects/trials throughout the four nations of the UK.

随着癌症发病率的上升，全球人口也在老龄化。在过去 10 年中，肿瘤学领域取得了巨大进步，早期诊断和治疗方案不断扩大，导致越来越多的老年人患上癌症。这意味着照顾老年癌症患者已成为肿瘤学日常工作的一部分。这部分患者通常患有老年综合症，体弱和需求复杂的比例较高，因此我们的临床服务必须做好准备，优化对这些患者的护理。虽然人们普遍认为全面的老年病学评估对患者有益，但只有一小部分患者能在癌症治疗期间通过专业团队获得这些评估。过去几年，英国在这一领域取得了重大进展。本次回顾的目的是向其他医疗保健系统介绍如何学习英国所做的工作。本文提供了 2020 年上一次审查的最新情况，详细介绍了正在实施并提供给患者的新服务，以及英国四个国家中新试点团队和研究项目/试验数量的增加情况。

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