Journal of geriatric oncology最新文献

{"title":"Primary endpoints in randomized controlled trials for older adults with cancer: A scoping review","authors":"Tomonori Mizutani ,&nbsp;Funato Sato ,&nbsp;Kohei Uemura ,&nbsp;Yukari Shimizu ,&nbsp;Tsuguo Iwatani ,&nbsp;Satoshi Kobayashi ,&nbsp;Masataka Sawaki ,&nbsp;Shimon Tashiro ,&nbsp;Tetsuya Tsuji ,&nbsp;Hiroshi Yamamoto ,&nbsp;Asao Ogawa ,&nbsp;Tetsuya Hamaguchi ,&nbsp;on behalf of the Geriatric Study Committee of the Japan Clinical Oncology Group, Japan","doi":"10.1016/j.jgo.2026.102895","DOIUrl":"10.1016/j.jgo.2026.102895","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults represent a growing proportion of patients with cancer. However, confirmatory randomized controlled trials (RCTs) continue to rely primarily on tumor-based endpoints such as overall survival (OS), which may overlook outcomes particularly important to older adults, including quality of life (QOL), functional status, and treatment tolerance. This review aimed to systematically characterize the primary endpoints used in confirmatory RCTs enrolling adults aged ≥65 years and to evaluate how novel endpoints reflecting patient priorities were defined and analyzed.</div></div><div><h3>Materials and methods</h3><div>PubMed, CINAHL, and the Cochrane Library were searched for English-language confirmatory RCTs exclusively enrolling adults aged ≥65 years with cancer and reporting a primary endpoint (up to January 19, 2024). Endpoints were classified as conventional (tumor-based) or novel (non-tumor-based). Data were extracted on endpoint definitions, measurement tools, and statistical approaches.</div></div><div><h3>Results</h3><div>Of 822 records identified, 66 RCTs met the eligibility criteria, yielding 71 primary endpoints. Conventional outcomes predominated (<em>n</em> = 53; 74.6%), with OS being the most frequent, followed by progression-free survival and disease-free survival. Novel endpoints (<em>n</em> = 18; 25.3%) included health-related QOL (HR-QOL), toxicity, geriatric assessment–based measures, composite endpoints, and patient satisfaction. HR-QOL was most commonly assessed using the European Organization for Research and Treatment of Cancer QLQ-C30. Definitions of toxicity and functional decline varied across studies. Variance assumptions were rarely reported, and minimal clinically important differences were inconsistently applied. Additional endpoints, such as quality-adjusted survival, overall treatment utility, and disability-free survival, were infrequently reported.</div></div><div><h3>Discussion</h3><div>Survival remains the predominant endpoint in confirmatory RCTs involving older adults with cancer, while patient-relevant outcomes are inconsistently incorporated. Addressing these gaps may facilitate more patient-centered trial designs and improve the real-world applicability of research findings for the aging cancer population.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102895"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078059","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":"Systematic review of frailty, functional status & comorbidities in older adults with multiple myeloma undergoing high dose therapy & autologous stem cell transplant","authors":"Nadine Abdallah ,&nbsp;Ashlyn O’Leary ,&nbsp;Cynthia M. Schmidt ,&nbsp;Sikander Ailawadhi ,&nbsp;Hira Mian ,&nbsp;Ashley Rosko ,&nbsp;Tanya M. Wildes","doi":"10.1016/j.jgo.2025.102846","DOIUrl":"10.1016/j.jgo.2025.102846","url":null,"abstract":"<div><h3>Introduction</h3><div>Improvements in supportive care strategies and growing evidence for benefit have led to increased use of autologous stem cell transplant (ASCT) in older patients with multiple myeloma (MM). However, the lack of standardized criteria for transplant eligibility often leaves the decision to the physician's clinical judgment. The roles of frailty/geriatric assessment tools, functional status, and comorbidity in selecting candidates and predicting transplant outcomes in older patients with MM remain uncertain. The purpose of this systematic review was to examine the measures of frailty, functional status, and comorbidity reported for older patients with MM who underwent ASCT and to evaluate their association with outcomes.</div></div><div><h3>Materials and methods</h3><div>On April 11, 2024, MEDLINE, EMBASE, and the Cochrane Library were searched for articles that included older adults (&gt;60 years) with MM addressing the use of ASCT or ASCT eligibility/ineligibility. We included retrospective and prospective studies that included (1) at least one measure of functional status and/or comorbidities and (2) at least one transplant-related outcome (response rate, transplant-related mortality).</div></div><div><h3>Results</h3><div>Twenty-five studies were included, four prospective and 21 retrospective. Of these, four studies utilized the International Myeloma Working Group (IMWG) frailty index, with some including frail patients. In one study utilizing a comprehensive geriatric assessment, &gt;50 % of older adults who were considered transplant-eligible reported dependence on ≥1 Instrumental Activities of Daily Living (IADL), severe limitations in vigorous activities, and/or self-reported weight loss. Eighteen studies reported a measure of functional status, most commonly Eastern Cooperative Oncology Group Performance Status; 19 studies reported a comorbidity measure, most commonly Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI). The comorbidity scores were generally low in patients who underwent ASCT (&lt;3). The 100-day treatment-related mortality ranged from 0 % to 6 %, with overall response rates were generally high across studies.</div></div><div><h3>Discussion</h3><div>There is wide variability in the tools used to assess characteristics of older adults who underwent ASCT across studies. The optimal tool for selecting older ASCT candidates remains undefined, but it is likely that no single measure can adequately capture overall health status. Prospective studies incorporating a multidimensional assessment are necessary to better define transplant eligibility in this population.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102846"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064215","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":"Pre-existing autoimmune disease and risk of immune checkpoint inhibitor (ICI) discontinuation in older adults with melanoma","authors":"S. Sharma ,&nbsp;H. Yao ,&nbsp;K. Gandhi ,&nbsp;A.L. Shaver ,&nbsp;S.W. Keith ,&nbsp;R.S. Seedor ,&nbsp;N. Nikita","doi":"10.1016/j.jgo.2026.102870","DOIUrl":"10.1016/j.jgo.2026.102870","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102870"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448724","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":"Real-world outcomes of frontline polatuzumab and impact of frailty in older adults with newly diagnosed diffuse large B-cell lymphoma (DLBCL), a multicenter study","authors":"P. Torka ,&nbsp;J. Meeko Manzano ,&nbsp;L. Chen ,&nbsp;V. Iyengar ,&nbsp;J. Chicola ,&nbsp;D. Russler-Germain ,&nbsp;V. Pizzuti ,&nbsp;A. Major ,&nbsp;Y. Sawalha ,&nbsp;D. Wallace ,&nbsp;N. Birrer ,&nbsp;A. Bock ,&nbsp;Y. Wang ,&nbsp;J. Rhodes ,&nbsp;J. Crombie ,&nbsp;J. Alderuccio ,&nbsp;P. Reidell ,&nbsp;B. Heyman ,&nbsp;C. Ujjani ,&nbsp;H.-J. Cherng ,&nbsp;S. Kambhampati Thiruvengadam","doi":"10.1016/j.jgo.2026.102880","DOIUrl":"10.1016/j.jgo.2026.102880","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102880"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449047","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":"Quality of life and grade 3+ toxicities in older men with advanced prostate cancer receiving geriatric assessment and/or remote symptom monitoring in a randomized trial","authors":"S. Abdallah ,&nbsp;A. Bukhari ,&nbsp;S. Sabesan ,&nbsp;W. Faiaz ,&nbsp;U. Emmenegger ,&nbsp;R. Jin ,&nbsp;D. Khalaf ,&nbsp;R. Lee ,&nbsp;D. Ly ,&nbsp;N. Jebanesan ,&nbsp;C. Hernandez Favela ,&nbsp;N. Segal ,&nbsp;M. Krzyzanowska ,&nbsp;E. Soto-Perez-de-Celis ,&nbsp;S.K. Sridhar ,&nbsp;L. Moody ,&nbsp;E. Papadopoulos ,&nbsp;R. Glicksman ,&nbsp;J. Bender ,&nbsp;A. Matthew ,&nbsp;S.M.H. Alibhai","doi":"10.1016/j.jgo.2026.102859","DOIUrl":"10.1016/j.jgo.2026.102859","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102859"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449278","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":"Survival benefit from evidence-based treatment for rectal cancer among older people – Analysis of SEER-medicare","authors":"Uma R. Phatak ,&nbsp;Yong Shan ,&nbsp;Yong-Fang Kuo","doi":"10.1016/j.jgo.2026.102851","DOIUrl":"10.1016/j.jgo.2026.102851","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment of stage III rectal cancer (RC) is complex and requires a multidisciplinary approach. Evidence-based guidelines (EBG) exist for the treatment of RC. We aimed to determine adherence to EBG in the treatment of stage III RC and the impact on survival in older adults.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective study of patients within the Surveillance, Epidemiology, and End Results program (SEER). We included adults with stage III RC between 2007 and 2018 with one pathologically confirmed primary tumor. We defined guideline-based care as receipt of: chemoradiation within 6 months of date of diagnosis; surgery within 6 months of completion of chemoradiation; and chemotherapy after surgery. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method. Multivariable Cox regression was performed to determine factors associated with survival.</div></div><div><h3>Results</h3><div>We identified 3962 patients, and 1945 (49.1%) were female. There were 1707 (43.1%) with a Charlson Comorbidity Index of zero. Of the total, 994 (25.1%) received all guideline-based treatments. Factors associated with lack of guideline-based care included age, comorbidities, income, and geographic location. Guideline-based care was associated with increased OS (HR: 0.55, 95% CI: 0.49–0.60) and CSS (HR: 0.59, 95% CI: 0.48–0.73).</div></div><div><h3>Discussion</h3><div>Although 43.1% of the cohort had a comorbidity index of zero, only 25.1% received all guideline-based treatments. Deviation from guideline-based care had a significant impact on OS. Our data show that more efforts can be made to recommend multimodal RC treatment among older adults.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102851"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010334","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":"Safety of CDK4/6 inhibitors in older patients: A FAERS-based analysis of serious and fatal adverse events","authors":"Fausto Petrelli ,&nbsp;Alessandro Iaculli ,&nbsp;Maria Chiara Parati ,&nbsp;Karen Borgonovo ,&nbsp;Mara Ghilardi ,&nbsp;Veronica Lonati ,&nbsp;Irene Angeli ,&nbsp;Lorenzo Dottorini","doi":"10.1016/j.jgo.2025.102820","DOIUrl":"10.1016/j.jgo.2025.102820","url":null,"abstract":"<div><h3>Introduction</h3><div>CDK4/6 inhibitors—abemaciclib, palbociclib, and ribociclib—are standard treatments for hormone receptor–positive, ERBB2 (HER2)-negative metastatic breast cancer. However, older adults are underrepresented in clinical trials, and age-related safety data remain limited in real-world settings.</div></div><div><h3>Materials and Methods</h3><div>We conducted a pharmacovigilance analysis using 44,100 individual case safety reports (ICSRs) from the FDA Adverse Event Reporting System (FAERS) involving patients aged ≥65 years treated with CDK4/6 inhibitors. Primary endpoints included serious adverse events (SAEs) and fatal outcomes. A secondary analysis compared adverse events between patients aged &lt;65 and 65–85 years, calculating odds ratios (ORs) for selected toxicities, including death, disease progression, diarrhea, and myelosuppression.</div></div><div><h3>Results</h3><div>Among older patients, 71.2 % of reports involved SAEs and 5.3 % were fatal. Abemaciclib was linked to higher risk of death in those aged 65–85 compared to younger adults (OR 1.53; 95 % CI 1.18–1.99), but lower odds of myelosuppression (OR 0.37; 95 % CI 0.26–0.53). Palbociclib showed similar death risk across age groups (OR 0.98; 95 % CI 0.92–1.05) and reduced risk of disease progression in older adults (OR 0.72; 95 % CI 0.61–0.84). Ribociclib showed no significant age-related difference in fatality (OR 1.01; 95 % CI 0.87–1.17) but had the highest overall death risk (OR 9.14 vs palbociclib; 95 % CI 7.70–10.84).</div></div><div><h3>Discussion</h3><div>Real-world data reveal drug- and age-specific toxicity differences. Ribociclib and abemaciclib pose higher risks in older adults compared to palbociclib, supporting the need for personalized treatment and careful monitoring in older patients.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102820"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735292","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":"Adding comprehensive geriatric assessment to standard of care in older patients with frailty and hematological cancer: A pilot and feasibility study","authors":"Nina Andersen ,&nbsp;Ann Kristine Weber Giger ,&nbsp;Dana Audrey Lawrie ,&nbsp;Wee Kheng Soo ,&nbsp;Cecilia Margareta Lund ,&nbsp;Jesper Ryg ,&nbsp;Henrik Frederiksen","doi":"10.1016/j.jgo.2025.102835","DOIUrl":"10.1016/j.jgo.2025.102835","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102835"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733164","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":"Geriatric prehabilitation prior to surgery for kidney tumors: Study protocol for Pre-KiT - A randomized controlled trial","authors":"Marie Juul-Haslund ,&nbsp;Cecilia M. Lund ,&nbsp;Troels G. Dolin ,&nbsp;Katrine Schou-Jensen ,&nbsp;Peter B. Østergren ,&nbsp;Anders Vinther ,&nbsp;Frederik F. Thomsen ,&nbsp;Mikkel Fode","doi":"10.1016/j.jgo.2026.102893","DOIUrl":"10.1016/j.jgo.2026.102893","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) primarily affects older adults who often present with frailty, increasing their risk of surgical complications and delayed recovery. Prehabilitation, incorporating exercise, nutrition, and psychological support, may improve postoperative outcomes. However, no studies have investigated prehabilitation prior to surgery for RCC. The aim is to assess whether a one-month multimodal prehabilitation program including geriatric interventions improves recovery in patients with frailty undergoing surgery for localized RCC ≤ 7 cm.</div></div><div><h3>Materials and methods</h3><div>60 patients, aged ≥65, with a Clinical Frailty Scale (CFS) score of 3–6 are randomized 1:1 to standard care or prehabilitation involving home-based exercise, geriatric assessment with tailored interventions, and smoking cessation support. The primary outcome is change in Quality of Recovery-15 (QoR-15) 21 days postoperatively. Secondary outcomes include changes in QoR-15, health-related quality of life (EQ-5D-5L) and physical performance (30-s chair-stand test, handgrip strength) assessed preoperatively, 1, 21 and 90 days postoperatively. Postoperative complications will be evaluated using the Clavien-Dindo classification, alongside a cost-effectiveness analysis. Long-term outcomes include 1- and 5-year recurrence-free, cancer-specific, and overall survival.</div></div><div><h3>Discussion</h3><div>Pre-KiT explores if a pragmatic geriatric prehabilitation strategy is effective and feasible for older frail patients with RCC. The intervention is designed for easy implementation in clinical practice: administered by a single healthcare professional, requiring only one additional hospital visit, and consists of home-based exercises. This low-resource approach also aims to minimize financial costs, which is of importance for implementation possibilities. If successful, it could improve standard care and outcomes after surgery.</div><div><em>Trial registration</em>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID: <span><span>NCT06745609</span><svg><path></path></svg></span>. Prospectively registered December 12th, 2024.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102893"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064167","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":"A literature review on hypothalamic–pituitary–adrenal (HPA) axis dysregulation in older adults with cancer: A missing link in predicting treatment toxicity?","authors":"Len De Nys","doi":"10.1016/j.jgo.2026.102854","DOIUrl":"10.1016/j.jgo.2026.102854","url":null,"abstract":"<div><div>Older adults with cancer face disproportionately high rates of severe treatment-related toxicities, yet current prediction tools rarely incorporate biomarkers that capture physiological resilience. The hypothalamic–pituitary–adrenal (HPA) axis—central to stress adaptation, immune regulation, and tissue repair—undergoes pronounced age-related alterations, including elevated basal cortisol, reduced dehydroepiandrosterone (DHEA) and its sulphate form DHEAS, and an increased cortisol:DHEA(S) ratio. These changes may impair immune function, delay recovery, and exacerbate vulnerability to treatment toxicity. This narrative review synthesizes mechanistic and clinical evidence linking HPA-axis dysregulation to treatment tolerance in geriatric oncology. Common patterns include blunted diurnal cortisol slopes, elevated evening cortisol, and low DHEA(S), which are associated with fatigue, functional decline, and reduced survival across cancer types. However, their predictive value for acute treatment toxicities remains underexplored due to methodological heterogeneity, lack of age-specific reference ranges, and absence from existing geriatric toxicity models. This review proposes a translational roadmap that prioritizes (1) standardization of salivary cortisol/DHEA(S) protocols; (2) prospective, age-stratified validation studies using standardized toxicity endpoints; (3) interventional testing of behavioral or pharmacological strategies to modulate HPA function; and (4) integration into oncology workflows and electronic decision-support tools. Incorporating endocrine biomarkers into risk prediction could refine treatment stratification, enable targeted supportive care, and ultimately improve outcomes for older patients with cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102854"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046851","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}