Arti Hurria, M.D.: A tribute to her shining legacy in the Alliance for Clinical Trials in Oncology

Adjei, Alex A.; Jc, Buckner; Cathcart-Rake, Elizabeth; Chen, H; Hj, Cohen; Dao, Dyda; Je, De Luca; Feliciano, Josephine; Ra, Freedman; Rm, Goldberg; J, Hopkins; Hubbard, Joleen M.; Jatoi, Aminah; Karuturi, Meghan Sri; Kemeny, Margaret; Gg, Kimmick; Hd, Klepin; Jl, Krok-Schoen; Jm, Lafky; Jg, Le-Rademacher; D, Li; Sm, Lichtman; Maggiore, Ronald J.; Mandelblatt, Jeanne S.; Va, Morrison; Hb, Muss; Mo, Ojelabi; Sedrak, Mina S.; Subbiah, Nanthini; Sun, Dong; Tuttle, Susan S.; VanderWalde, Noam A.; Wildes, Tanya M.; Wong, Melisa L.; Woyach, Jennifer A.

doi:10.1016/j.jgo.2019.05.011

Cited by 5 publications

(3 citation statements)

References 41 publications

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“…In the United States, the Alliance for Clinical Trials in Oncology has advocated for a standardized geriatric assessment in therapeutic trials enrolling older adults. 32 In therapeutic clinical trials, GA has been shown to increase understanding of tolerability through (1) better characterization of the study sample beyond age alone, (2) improved recognition of factors associated with poor tolerability, (3) integration in random assignment to guide treatment decisions, and (4) evaluation of how treatment affects outcomes important to older adults. From 2000 to 2017, only 41.5% of 41 phase II-III trials of systemic therapy exclusively enrolling older adults with cancer included an assessment of comorbidity or frailty and only 36.6% accounted for death from other causes.…”

Section: Evaluating Aging-related Conditions That Affect Tolerability...mentioning

confidence: 99%

Understanding Treatment Tolerability in Older Adults With Cancer

Flannery

Culakova

Canin

et al. 2021

JCO

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Section: Evaluating Aging-related Conditions That Affect Tolerability...mentioning

confidence: 99%

Understanding Treatment Tolerability in Older Adults With Cancer

Flannery

Culakova

Canin

et al. 2021

JCO

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“…Cancer June 15, 2022 patient frailty and functionality. 10 On average, even the somewhat longer cancer geriatric assessments take less than half an hour to complete, an estimate that combines both patient and clinic personnel time. 11 Importantly, in patients with cancer, the geriatric assessment has proven to be a better predictor of adverse events than the far more commonly used and cited Eastern Cooperative Oncology Group performance score or the Karnofsky performance score.…”

mentioning

confidence: 99%

“…Cancer geriatric assessments enable clinicians to predict adverse events from cancer therapy. Various versions of geriatric assessments exist, but somewhat common features include the incorporation of patient‐reported outcomes and a multidimensional assessment of domains that include patient frailty and functionality 10 . On average, even the somewhat longer cancer geriatric assessments take less than half an hour to complete, an estimate that combines both patient and clinic personnel time 11 .…”

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confidence: 99%

Equity

Wieland

Jordan

Jatoi

2022

Cancer

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Equity is the truth in action." 1 In this issue of Cancer, Williams and colleagues 2 provide important observations that allow for actionable opportunities to improve the lives of older patients with cancer, most notably those patients of diverse backgrounds, including those who are Black, live in the Deep South, and have been diagnosed with a gastrointestinal malignancy. These investigators focused on the present-day, extant circumstances that epidemiologists have been writing about for decades: More than 50 million Americans are now 65 years old or older; are at increasingly high risk for cancer because of aging; and are, as a cohort, growing in number. 3 More than 9 million of these aging Americans are Black Americans, who, compared with Whites, had previously experienced a relative reduction in disparities in life expectancy from 7 to 3.6 years between 1990 and 2018 but, for unclear reasons, have more recently seen a faltering in these trends of favorable comparative longevity, even before the coronavirus 2019 pandemic. 4 Furthermore, as a whole, older patients diagnosed with cancer are far from homogeneous with notable differences in their underlying health, their ability to take care of themselves, and their capacity to tolerate cancer therapy; these circumstances only heighten the challenge of knowing how best to deliver cancer care to each of these older individuals in the most optimal manner. 5 In this context, the work from Williams and colleagues 2 is noteworthy. Recruiting 553 older patients who had been diagnosed with a gastrointestinal cancer and who had consented to be recruited into a single-institution registry, these investigators examined baseline differences in health status according to race. These investigators reported that Black patients manifested higher rates of frailty, which has been defined by others as an "aging related … physiologic decline [with] an increased burden of symptoms, including weakness and fatigue, medical complexity, and reduced tolerance to medical and surgical interventions." 6,7 Black patients with cancer also self-reported lower levels of activities of daily living and instrumental activities of daily living. In fact, Black patients were almost twice as likely to manifest limitations in activities of daily living. Even after adjustments for patient age, sex, highest attained educational level, cancer type, cancer stage, and other morbidities, these racial differences persisted. As the authors themselves point out, these findings are salient because others have shown that such observations portend a higher likelihood of severe side effects from cancer therapy and of worse all-cause mortality. Thus, this underlying frailty and these underlying limitations in activity serve as independent factors that suggest some Black patients with cancer are at risk for suffering poor cancer outcomes.To be clear, we accept that "race and ethnicity are social constructs, without scientific or biological meaning." 8 It behooves all of us to reject these observed differences in frail...

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