Elderly selection on geriatric index assessment

Geriatric assessment in clinical practice for patients with stage IV non-small-cell lung cancer: The Grup de Investigació I Divulgació Oncològica experience

“…However, doubts persist as to the benefits of treating vulnerable patients. Considering that current trials generally exclude these patients, our study not only supports the use of GA for selecting patients for treatment, but it also strongly highlights the need for further research focused on comprehensive assessments of older patients to guide first‐line lung cancer treatment (Tomasini et al, ).…”

“…Similar results for comorbidity were obtained in a previous study by our group (Gironés et al, 2011), and the ESOGIA trial found a correlation between CCI and prognosis (Maione et al, 2005), but this has not yet been confirmed by other studies. Indeed, it seems that advanced NSCLC patients with a poor prognosis are more likely to die of lung cancer than of any other comorbidity (Tomasini et al, 2016). The assessment of comorbidity type and severity is probably more appropriate for advanced NSCLC patients than evaluation of the number of comorbidities.…”

“…However, as older patients constitute a heterogeneous population, PS scales may not be useful for evaluating all aspects of ageing (Wildiers et al, ). Consequently, comprehensive assessment of older patients is needed if they are to be classified as medically fit or unfit, and to provide guidance for physicians when deciding who qualifies for first‐line lung cancer treatment (Tomasini, Mascaux, & Barlesi, ). To this end, several guidelines recommend the use of a comprehensive geriatric assessment (GA) (Pallis et al, ; Wildiers et al, ) for detecting unexplored problems, such as functional impairment, cognitive decline, comorbidities, depressive symptoms and malnutrition.…”

“…Although a myriad of publications have supported its use, the real implementation of GA into clinical practice has so far been limited (Hurria, Cohen, & Extermann, 2010;Tomasini et al, 2016). In Spain, some hospitals have implemented GA for older patients in recent years (Gironés, Torregrosa, Gomez-Codina, et al, 2012;Maestu et al, 2007;Molina-Garrido & Guillen-Ponce, 2011;Peiro et al, 2012).…”