The impact of comprehensive geriatric assessment for optimal treatment of older patients with cancer: A randomized parallel-group clinical trial

Abstract

The aim was to investigate if oncologic treatment decision based on G8 screening followed by comprehensive geriatric assessment (CGA) and a multidisciplinary team conference in patients with G8 ≤ 14 was better than treatment decision based on standard assessment. ClinicalTrials.gov Identifier: NCT02671994. Materials and Methods: From January 2016 to June 2018, 96 patients with cancer, aged ≥70 years, were included. Patients were randomized to treatment decision based on the oncologist's clinical judgement (control) or based on screening with G8. If G8 N 14 treatment decision was made as in the control group and if G8 ≤ 14, patients were referred to CGA including intervention as needed and treatment decision after a multidisciplinary team conference (MDT). Results: The study was closed early. 47 patients were randomized to the control group and 49 to the intervention group; 28 had a G8 ≤ 14, 24 of whom attended CGA. In the intervention group 48% completed treatment as planned compared to 54% in the control group (p = .208). Thirty-eight percent experienced grade 3-4 toxicity in the control group compared with only 20% in the intervention group (p = .055). Median overall survival (OS) was 14.2 months in the control group and 19.1 months in the intervention group (p = .911). Median progression-free survival (PFS) was 9.0 months in the control group and 7.8 months for the intervention group (p = .838). Conclusion: Treatment decision based on G8 screening followed by CGA had no impact on completion rate of planned oncologic treatment, OS or PFS, but resulted in a borderline significant lower incidence of grade 3-4 toxicity.

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

“…Data sources differed between the studies with some overlap as shown in Table 1. Three studies used MDT records (13,25,26), three used medical records (13,26,27), five used institutional registries (7,(10)(11)(12)27) and six used state or national administrative datasets or registries (8,9,(27)(28)(29)(30). Of the studies identified, 10/13 used data linkage, registry and/ or administrative data (7-12,27-30) with 3/13 basing their analyses on MDT or medical records (13,25,26).…”

“…Three studies used MDT records (13,25,26), three used medical records (13,26,27), five used institutional registries (7,(10)(11)(12)27) and six used state or national administrative datasets or registries (8,9,(27)(28)(29)(30). Of the studies identified, 10/13 used data linkage, registry and/ or administrative data (7-12,27-30) with 3/13 basing their analyses on MDT or medical records (13,25,26). The three largest studies (with >10,000 cases) based their analyses on large, national registry and administrative datasets (9,28,30).…”

Nutritional Status and Its Contributing Factors among Older Adults with Cancer Receiving Chemotherapy

“…On the same line, a study in Belgium carried out by Quinten et al (2019) found that most older adults who undergo chemotherapy were at risk of malnutrition or malnourished. Another study conducted by Nadaraja et al (2019) in Denmark reported that nearly three-quarters of older adults with cancer were at risk of malnutrition or malnourished. Controversy, Luciani et al (2015) conducted a study in Italy reported that over three-quarters of the studied patients had normal nutritional status, and one-fifth were at risk of malnutrition.…”

Predictive Value of Geriatric Oncology Screening and Geriatric Assessment in Older Patients with Solid Cancers: Protocol for a Danish prospective cohort study (PROGNOSIS-G8)

“…The G8's well-established, strong diagnostic performance [16,[45][46][47] and successful application in previous departmental research [48,49], made the G8 our primary choice of geriatric oncology screening tool. However, as the G8 is developed based on the Mini Nutritional Assessment, much emphasis is placed on food intake and weight loss.…”