Systemic Treatment of Cancer in the Older-Aged Person

Balducci, Lodovico

doi:10.1007/978-3-319-23588-2_1

Cited by 2 publications

(6 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gastroesophageal adenocarcinoma is an age-related disease and affects mainly older people as the incidence rates increase with age [1,2]. As a result, the management of these cancers in the elderly is an increasingly common problem.…”

Section: Introductionmentioning

confidence: 99%

Localized Gastroesophageal Adenocarcinoma in the Elderly: Is Age a Factor Associated with Suboptimal Treatment?

et al. 2022

View full text Add to dashboard Cite

Introduction: Gastroesophageal adenocarcinoma is relatively common in elderly patients as the incidence increases with age. However, the optimal treatment approach is not well established in this group of patients. The aim of this study is to review our experience for localized gastroesophageal adenocarcinoma in patients aged ≥ 80 years and to assess association between patient characteristics, clinical factors and overall survival in order to optimize the therapeutic approaches for this population. Methods and Materials: patients ≥ 80 years old treated for localized gastroesophageal adenocarcinoma were retrospectively analyzed. Survival curves were estimated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were applied to assess the association between patient characteristics and overall survival (OS). Factors that were significant in the multivariate model were included in the final reduced model. Results: 127 patients ≥ 80 years old, were included in this study with median age of 83 years. The median follow-up time was 3.2 years, and median OS was 2.5 years (95% CI: 2.0-3.1 years). Independent prognostic factors for OS were Eastern Cooperative Oncology Group (ECOG) performance status (PS) (p=0.003), baseline clinical stage (p=0.01), and surgery (p=0.001). ECOG PS, tumor location, baseline stage, tumor grade and surgery were included in the final reduced model. Conclusion: Surgical treatment, can improve survival in elderly patients. Therapeutic decisions should be based on the patients’ general condition rather that age alone.

show abstract

Section: Introductionmentioning

confidence: 99%

Localized Gastroesophageal Adenocarcinoma in the Elderly: Is Age a Factor Associated with Suboptimal Treatment?

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Efficient management must consider many factors, such as disease, chronological and physiological age, comorbidities, and concomitant medications. 5,6…”

Section: Introductionmentioning

confidence: 99%

“…Yet, with the advent and introduction of novel targeted agents—including Bruton tyrosine kinase (BTK) and B‐cell lymphoma‐2 inhibitors—additional therapeutic options are now available, resulting in higher efficacy and a more favorable safety profile, providing the possibility of personalized treatment 3 . The opportunity for a tailored treatment is particularly essential for older patients, as aging is associated with more significant comorbidity and reduced functional reserve, negatively impacting patients’ tolerance to treatments 4–6 . Thus, treatment choice may result challenging and, as such, requires shared decision‐making involving both the physician and the patient with CLL.…”

Section: Introductionmentioning

confidence: 99%

“…3 The opportunity for a tailored treatment is particularly essential for older patients, as aging is associated with more significant comorbidity and reduced functional reserve, negatively impacting patients' tolerance to treatments. [4][5][6] Thus, treatment choice may result challenging and, as such, requires shared decision-making involving both the physician and the patient with CLL. Efficient management must consider many factors, such as disease, chronological and physiological age, comorbidities, and concomitant medications.…”

Section: Introductionmentioning

confidence: 99%

“…Efficient management must consider many factors, such as disease, chronological and physiological age, comorbidities, and concomitant medications. 5,6 Few information is available about potential differences in the way patients and physicians rate the importance of efficacy, toxicity, and logistics of the administration for the choice of CLL treatment. Yet, knowledge of such preferences could improve share decision-making by guiding discussions among patients and physicians themselves.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

et al. 2022

View full text Add to dashboard Cite

Several treatment options are available for chronic lymphocytic leukemia (CLL) and, for this reason, treatment choice can result challenging after introducing oral targeted agents. This study aims at comparing patients’ and hematologists’ preferences for attributes of CLL treatments. An online cross-sectional survey has been delivered to clinicians and patients affected by CLL in Italy. A discrete choice experiment has been conducted so to estimate each attribute’s relative importance (RI) and assess the preference weight for each level of each attribute. An expert panel agreed on investigating the following attributes: progression-free survival (PFS) and measurable residual disease, route of administration/therapy duration and follow-up frequency, incidence of diarrhea (episodes/day), serious infections (grade 3 or 4), and atrial fibrillation. Overall, 746 patients and 109 clinicians accessed the survey, and 215 and 69, respectively, filled it in. The most important attributes were PFS (RI 30%) for hematologists and the risk of severe infections (RI 24%) for patients. Clinicians rated preference for maximum efficacy and lowest risk of severe infection very high (30%). Both patients and clinicians preferred oral administration while considering duration of therapy less relevant. The frequency of hospital appointments was negligible for patients, while clinicians preferred a quarterly frequency. Considering all attributes, diarrhea was weighted more by clinicians than by patients. Atrial fibrillation was not relevant for clinicians, while it was not negligible for patients. In conclusion, clinicians and patients favor an oral therapy, including continuous treatment, if associated with prolonged PFS, albeit with particular attention to the risk of serious infections.

show abstract

Systemic Treatment of Cancer in the Older-Aged Person

Cited by 2 publications

References 39 publications

Localized Gastroesophageal Adenocarcinoma in the Elderly: Is Age a Factor Associated with Suboptimal Treatment?

Localized Gastroesophageal Adenocarcinoma in the Elderly: Is Age a Factor Associated with Suboptimal Treatment?

What Are the Attributes Prioritized in the Choice of Therapy in Chronic Lymphocytic Leukemia? A Patient-physician Cross-matching Analysis of a Discrete Choice Experiment

Contact Info

Product

Resources

About