Journal of geriatric oncology最新文献

{"title":"Impairments in geriatric assessment and their associations with different grip strength cutoffs and components of the Short Physical Performance Battery among older adults with cancer","authors":"Saul Cobbing ,&nbsp;Shabbir M.H. Alibhai ,&nbsp;Rana Jin ,&nbsp;Susie Monginot ,&nbsp;Efthymios Papadopoulos","doi":"10.1016/j.jgo.2025.102201","DOIUrl":"10.1016/j.jgo.2025.102201","url":null,"abstract":"<div><h3>Introduction</h3><div>The grip strength test is often used during geriatric assessment (GA) to assess muscle strength in older adults. However, it is unclear which grip strength cutoffs are most relevant to older adults in the context of GA. Physical performance during GA is often assessed via the Short Physical Performance Battery (SPPB). Whether the SPPB is superior to two of its individual components (4-m gait speed and the 5-chair stand test) for identifying GA abnormalities is unknown. The objectives of this study were (i) to identify which grip strength thresholds are associated with impairments in GA domains and with an abnormal GA overall and (ii) to examine whether total SPPB score is a stronger indicator of an abnormal GA and each of its domains than 4-m gait speed and the 5-chair stand test.</div></div><div><h3>Materials and Methods</h3><div>This was a retrospective cohort study of older adults with cancer aged ≥65 years who had undergone a GA prior to treatment. Grip strength and the SPPB were completed during GA. We examined three different grip strength cutoffs: (i) European Working Group on Sarcopenia in Older People 2 (EWGSOP2); (ii) the Foundation for the National Institutes of Health (FNIH); and (iii) the Sarcopenia Definitions and Outcomes Consortium (SDOC). Low SPPB was defined as a score of ≤9 out of 12 points. A score of ≤3 out of 4 points was used to identify abnormalities in the 4-m gait speed and 5-chair stand test. Multivariable logistic regression was used to address the study objectives.</div></div><div><h3>Results</h3><div>A total of 475 participants (mean age: 80.7 years, 42.9 % female) were included. The FNIH grip strength criteria had a higher discriminative ability of an abnormal GA (area under the curve [AUC] = 0.646) than the EWGSOP2 and the SDOC criteria. Compared to the SPPB and the 5-chair stand test, the 4-m gait speed was the strongest indicator of an abnormal GA (AUC = 0.737). The addition of low grip strength improved the performance of the SPPB (AUC Δ = +0.05) and gait speed (AUC Δ = +0.04) for identifying an abnormal GA.</div></div><div><h3>Discussion</h3><div>Low grip strength per the FNIH and slow gait speed are of clinical relevance during GA.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102201"},"PeriodicalIF":3.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global prevalence of falls among older adults with cancer: A systematic review and meta-analysis","authors":"Ganesh Bushi ,&nbsp;Shilpa Gaidhane ,&nbsp;Ashok Kumar Balaraman ,&nbsp;G. Padmapriya ,&nbsp;Irwanjot Kaur ,&nbsp;Madan Lal ,&nbsp;Suhaib Iqbal ,&nbsp;G.V. Siva Prasad ,&nbsp;Atreyi Pramanik ,&nbsp;Teena Vishwakarma ,&nbsp;Praveen Malik ,&nbsp;Promila Sharma ,&nbsp;Ankit Punia ,&nbsp;Megha Jagga ,&nbsp;Mahendra Pratap Singh ,&nbsp;Doddolla Lingamaiah ,&nbsp;Muhammed Shabil ,&nbsp;Rachana Mehta ,&nbsp;Sanjit Sah ,&nbsp;Quazi Syed Zahiruddin","doi":"10.1016/j.jgo.2025.102202","DOIUrl":"10.1016/j.jgo.2025.102202","url":null,"abstract":"<div><h3>Introduction</h3><div>Falls are a significant health concern among older adults, particularly those with cancer, due to aging-related frailty, treatment-related adverse effects, and comorbidities. Existing reviews have highlighted the burden of falls in this population; however, the absence of a comprehensive meta-analysis to synthesize pooled results from relevant studies has limited the generalizability of their findings. This systematic review and meta-analysis aimed to estimate the global prevalence of falls among older adults with cancer and provide evidence to guide prevention efforts.</div></div><div><h3>Materials and Methods</h3><div>A systematic search of PubMed, Embase, and Web of Science databases was conducted through October 2024, following PRISMA 2020 guidelines. Studies reporting fall prevalence in patients with cancer aged 65 years or older were included. Pooled prevalence estimates were calculated using a random-effects meta-analysis.</div></div><div><h3>Results</h3><div>Seventy-six studies, including 177,212 participants, met the inclusion criteria. The pooled prevalence of falls was 24 % (95 % confidence interval [CI], 20; 28), with significant heterogeneity (I² = 100 %). Fall prevalence increased with follow-up duration: short-term 12 % (95 % CI, 5.2; 28.4), medium-term 23 % (95 % CI, 18.9; 29.5), and long-term 54 % (95 % CI, 14.9; 89.1) studies (<em>p</em> = 0.13). Older adults with breast cancer had the highest prevalence of falls at 31 % (95 % CI, 17; 48), while patients with colorectal cancer had the lowest at 15 % (95 % CI, 1; 78) (<em>P</em> ≤0.001). Fall prevalence ranged from 19 % in Australia to 24 % in North America (<em>p</em> = 0.89).</div></div><div><h3>Discussion</h3><div>Falls are frequent among older adults with cancer, with prevalence varying by cancer type, geographic region, and follow-up duration.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102202"},"PeriodicalIF":3.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422036","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":"Treatment goals, desire for disclosure, and perception of cancer treatment outcomes in older patients with cancer: An observational study from a tertiary care center in India","authors":"Vanita Noronha ,&nbsp;Jatin Choudhary ,&nbsp;Anant Ramaswamy ,&nbsp;Anupa Pillai ,&nbsp;Abhijith Rajaram Rao ,&nbsp;Anita Kumar ,&nbsp;Ratan Dhekale ,&nbsp;Sarika Mahajan ,&nbsp;Anuradha Daptardar ,&nbsp;Lekhika Sonkusare ,&nbsp;Manjusha Vagal ,&nbsp;Purabi Mahajan ,&nbsp;Shivshankar Timmanpyati ,&nbsp;Vikram Gota ,&nbsp;Ankush Gorakh Shetake ,&nbsp;Akash Pawar ,&nbsp;Kumar Prabhash","doi":"10.1016/j.jgo.2025.102198","DOIUrl":"10.1016/j.jgo.2025.102198","url":null,"abstract":"<div><h3>Introduction</h3><div>There is little information regarding the perceptions of older adults with cancer about intent of therapy, desire for disclosure of diagnosis and prognosis, treatment priorities, and influencing factors.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective analysis of a prospectively maintained database at the geriatric oncology clinic of the Tata Memorial Hospital, Mumbai (India) where older patients with cancer (aged ≥60 years) were referred by their primary treating oncologists. Our three objectives were to understand the goals of cancer-directed therapy, evaluate the proportion of patients who desired disclosure of diagnosis and prognosis, and assess the proportion of patients who did not accurately understand the intent of cancer-directed therapy. We assessed the association of demographic and clinical factors and the results of geriatric assessment with patients' perceived intent of therapy and their desire for disclosure of diagnosis and prognosis using chi-square test and multivariate logistic regression.</div></div><div><h3>Results</h3><div>Between November 2020 and December 2023, we enrolled 2599 patients. The median age was 67 years (IQR, 63–72), 77.7 % were male, and 62.6 % were being treated with palliative intent. Most patients (71.7 %) wanted a full disclosure of the diagnosis and prognosis; in 23.1 % of the cases, family members refused permission to disclose these details to the patients. Factors associated with a decreased desire for disclosure included palliative intent of therapy, female sex, illiteracy, performance status ≥2, and impaired function. Among patients receiving curative intent therapy, 79.3 % prioritized complete cure, 14.6 % prioritized quality of life (QoL)/symptom relief, and 5.1 % prioritized prolongation of life. Among patients receiving palliative intent therapy, 79.1 % prioritized QoL/symptom relief and 20.6 % prioritized prolongation of life. Misperception of intent of therapy was noted in 34.1 % of patients and was significantly higher in patients on palliative intent treatment (44.5 %) than patients receiving curative intent therapy (16.7 %). Factors associated with increased misperception of intent of therapy were female sex, illiteracy, and palliative intent therapy.</div></div><div><h3>Discussion</h3><div>Understanding the perceptions and priorities of older individuals with cancer will help to identify key areas of intervention to meaningfully improve shared decision making, harmonize cancer treatment, and empower patients to make appropriate decisions regarding their care.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102198"},"PeriodicalIF":3.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422037","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":"Updates on myeloma in older adults: Conference summary from the 2024 International Myeloma Society annual meeting","authors":"Sandra Frimpong ,&nbsp;Aminatta Tejan-Kamara Mitchell ,&nbsp;Hira Mian ,&nbsp;Tanya M. Wildes","doi":"10.1016/j.jgo.2025.102199","DOIUrl":"10.1016/j.jgo.2025.102199","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102199"},"PeriodicalIF":3.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422041","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":"How oncologists assess and consider cognition in clinical decision-making with older adults.","authors":"Romy Van Rickstal, Lieve Van den Block, Lore Decoster, Christine Ritchie, Alys Wyn Griffiths, Joni Gilissen","doi":"10.1016/j.jgo.2025.102204","DOIUrl":"https://doi.org/10.1016/j.jgo.2025.102204","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102204"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424890","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":"Immunological changes and recovery-related factors in older patients with colon cancer: A pilot trial","authors":"Byeo Lee Lim ,&nbsp;Young Il Kim ,&nbsp;Jong Lyul Lee ,&nbsp;Chan Wook Kim ,&nbsp;Yong Sik Yoon ,&nbsp;Yousun Ko ,&nbsp;Kyung Won Kim ,&nbsp;In Ja Park","doi":"10.1016/j.jgo.2025.102200","DOIUrl":"10.1016/j.jgo.2025.102200","url":null,"abstract":"<div><h3>Introduction</h3><div>Immunity in older patients with colon cancer differs from that in younger patients. Specifically, concerns regarding postoperative recovery and immunity have prompted the development of personalized treatment options for older patients with colon cancer. This study aimed to assess the differences in immunological factor-related parameters and postoperative recovery between patients aged ≥70 years and &lt; 70 years.</div></div><div><h3>Material and Methods</h3><div>This pilot study included 75 patients who underwent surgical resection for colon cancer between September 2023 and February 2024 at Asan Medical Center, Seoul, Korea. Patients were divided into two age groups: ≥70 years and &lt; 70 years.</div><div>The clinicopathological features associated with recovery, and the association among recovery, immunological factors, and clinical characteristics were analyzed. The EuroQol-5 Dimensions-3 questionnaire scores, which reflect the subjective perspectives of patients, were also compared between the two groups.</div></div><div><h3>Results</h3><div>There were 29 patients in the ≥70 years group and 46 patients in the &lt;70 years group. The ≥70 years group exhibited significantly higher IL-6 levels than the &lt;70 years group both preoperatively (6.71 vs. 4.27, <em>P</em> = 0.04) and on postoperative day 21 (POD#21) (13.49 vs. 2.94, <em>P</em> = 0.03). The average NK cell counts were consistently higher in the ≥70 years group across all time points: preoperatively (24.54 vs. 13.87, <em>P</em> &lt; 0.001), POD#3 (24.32 vs. 15.39, P &lt; 0.001), and POD#21 (33.04 vs. 22.47, P &lt; 0.001). While a greater proportion of patients in the ≥70 years group had below-average preoperative EQ-5D levels, this difference was not statistically significant (20.7 % vs. 17.4 %, <em>P</em> = 0.96).</div></div><div><h3>Discussion</h3><div>Immunological factors, such as IL-6 levels and the number of natural killer cells, did not diminish in patients aged ≥70 years. Furthermore, postoperative recovery was not prolonged in this group.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102200"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377773","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":"Age-stratified analysis of health-related quality of life in patients with early-stage breast cancer receiving adjuvant radiation therapy and endocrine therapy","authors":"Keva Li ,&nbsp;Manjeet Chadha ,&nbsp;Erin Moshier ,&nbsp;Barry S. Rosenstein","doi":"10.1016/j.jgo.2025.102195","DOIUrl":"10.1016/j.jgo.2025.102195","url":null,"abstract":"<div><h3>Introduction</h3><div>Health-related quality of life (HRQoL) in older patients with breast cancer (BC) (≥70 years) is not well studied. This study assesses aging-related differences in patient-reported outcomes among estrogen receptor-positive (ER+) patients with BC treated with breast conservation surgery (BCS), radiation therapy (RT), and endocrine therapy (ET).</div></div><div><h3>Materials and Methods</h3><div>Among the 2,057 patients with ER+ early-stage BC enrolled in the prospective multicenter REQUITE study, 1,003 patients receiving adjuvant RT + ET as the only systemic therapy constitute our study population. Patients were stratified by age into younger (&lt;70 years, <em>n</em> = 810 patients) and older (≥70 years, <em>n</em> = 193 patients) groups. Prospectively collected HRQoL was measured using the validated European Organization for Research and Treatment of Cancer (EORTC) quality of life of cancer patients (QLQ-30) and breast cancer–specific quality of life (QLQ-BR23), and Multidimensional Fatigue Inventory (MFI-20) measures at baseline following BCS and pre-adjuvant treatment, post-RT, and at one-year, two-year, and three-year intervals. Statistical analysis involved a mixed model analysis of variance, weighted by propensity scoring.</div></div><div><h3>Results</h3><div>Older patients had a higher burden of comorbidities, larger tumor size, and higher rates of N1 disease compared to the younger group. RT boost to the lumpectomy site was more often delivered in younger participants (72 %) compared to older (50 %). Younger patients predominately received tamoxifen (63.5 %), while older patients more commonly received aromatase inhibitors (67.4 %). Throughout the follow-up, we observed that the younger patients showed greater recovery in QoL domains including sexual enjoyment, systemic side effects, breast symptoms, global health status, and emotional, physical, and social functioning compared to the older group. Cognitive function, which declined from baseline in both groups, improved over time in younger participants but persisted at lower levels in older patients at the three-year follow-up period.</div></div><div><h3>Discussion</h3><div>Adjuvant treatments differentially impacted HRQoL, with older patients experiencing greater and more persistent adverse effects compared to younger counterparts. These findings underscore the need for tailored interventions that address the unique challenges in HRQoL recovery among older BC survivors.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102195"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143297522","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":"Supporting older adults with cancer and their support person through geriatric assessment and remote exercise and education: The SOAR study protocol","authors":"Nirusha Jebanesan ,&nbsp;Shabbir M.H. Alibhai ,&nbsp;Daniel Santa Mina ,&nbsp;Jennifer Jones ,&nbsp;Nicholas Legacy ,&nbsp;Laura Freeman ,&nbsp;Ainslee Smith ,&nbsp;Saul Cobbing ,&nbsp;Neera Vadali ,&nbsp;Shiuhang Lo ,&nbsp;Kian Godhwani ,&nbsp;Ferozah Nasiri ,&nbsp;Maryjo Antonio ,&nbsp;Douglas Stephens ,&nbsp;Eric Pitters ,&nbsp;Fay Bennie ,&nbsp;Anne Stephens ,&nbsp;Janet Papadakos ,&nbsp;Linda Cerullo ,&nbsp;Margaret Zjadewicz ,&nbsp;Martine Puts","doi":"10.1016/j.jgo.2025.102194","DOIUrl":"10.1016/j.jgo.2025.102194","url":null,"abstract":"<div><h3>Introduction</h3><div>Frail older adults receiving cancer treatment are at heightened risk of adverse outcomes. Despite the known benefits of exercise during cancer treatment to improve well-being, few exercise studies focus on frail older adults receiving cancer treatment and their support person. Geriatric assessment (GA) is often recommended prior to the start of treatment for frail adults with cancer, but combining the GA with a planned exercise regimen remains unexplored. This study aims to determine the feasibility and acceptability of implementing geriatric assessment and management (GAM) in combination with virtual chair-based exercise (CBE) and health education for frail older adults with cancer and their support persons.</div></div><div><h3>Materials and Methods</h3><div>This phase 2 randomized controlled trial will include patients aged 70 years and above with a lung, gastrointestinal, or genitourinary cancer referred for first- or second-line chemotherapy, immunotherapy, or targeted therapy. Patients must be frail (≥3 on the Vulnerable Elders Survey), sedentary on the Godin Leisure Time Activity Questionnaire (&lt;90 min of moderate/intense activity per week), have English proficiency with ability to consent, a physician-estimated life expectancy of <u>at least</u> six months, and deemed safe to exercise. Each older adult will be invited to bring a support person to participate in the study. Patients will be randomized 1:1 to GAM combined with online CBE and health education for 12 weeks or waitlist control. Participating support persons will follow the same intervention group. Primary endpoints for feasibility and acceptability will be recruitment rate, retention, adherence, and data collection. Outcome measures include physical activity, function, fatigability, quality of life, treatment toxicity, and unplanned hospital visits. Outcome measures will be used to obtain estimates of the effect size and feasibility analysis needed for designing a phase 3 study. The study will take place at two hospitals in Toronto, Canada.</div></div><div><h3>Discussion</h3><div>This study will investigate the feasibility, acceptability, and obtain preliminary estimates of the outcomes of GAM plus CBE and health education in preventing functional decline and improving quality of life in frail older adults receiving cancer treatment and their support persons. The results will help to design a definitive phase 3 randomized controlled trial.</div></div><div><h3>Trial registration</h3><div>The trial is registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (Registration Number: <span><span>NCT05509751</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 3","pages":"Article 102194"},"PeriodicalIF":3.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remarks regarding the predictive ability of the Cancer and Aging Research Group chemotherapy toxicity calculator in haematologic malignancy","authors":"Cristian Orlando Porras Bueno ,&nbsp;Miguel Oswaldo Cadena Sanabria ,&nbsp;Miguel Enrique Ochoa Vera ,&nbsp;Angela Maria Peña Castellanos ,&nbsp;Luis Antonio Salazar Montaña ,&nbsp;Manuel Leonidas Rosales Acevedo ,&nbsp;María Lucrecia Luna González ,&nbsp;Claudia Lucia Sossa Melo","doi":"10.1016/j.jgo.2025.102193","DOIUrl":"10.1016/j.jgo.2025.102193","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102193"},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023594","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 effectiveness and cardiovascular safety of abiraterone versus enzalutamide amongst older patients diagnosed with metastatic castration-resistant prostate cancer","authors":"Charles E. Gaber ,&nbsp;Ebere Okpara ,&nbsp;Abdullah I. Abdelaziz ,&nbsp;Jyotirmoy Sarker ,&nbsp;Kent A. Hanson ,&nbsp;Lubna Hassan ,&nbsp;Fang-Ju Lin ,&nbsp;Todd A. Lee ,&nbsp;Natalie M. Reizine","doi":"10.1016/j.jgo.2024.102148","DOIUrl":"10.1016/j.jgo.2024.102148","url":null,"abstract":"<div><h3>Introduction</h3><div>Abiraterone and enzalutamide are both approved in the United States for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The objective of this study was to compare the real-world effectiveness and cardiovascular safety of these agents, drawing from a cohort of older adult patients diagnosed with mCRPC.</div></div><div><h3>Materials and methods</h3><div>The Surveillance, Epidemiology, and End Results-Medicare database was used to conduct an observational study comparing three-year overall survival and one-year risk of major adverse cardiovascular events (MACE) between initiators of abiraterone or enzalutamide between September 2012 and June 2017. Inverse-probability-of-treatment weighting was used to balance measured confounders. MACE was defined as a hospitalization for myocardial infarction, heart failure, or ischemic event (stroke or transient attack). Results were additionally stratified by levels of a claims frailty index (robust, prefrail, frail) and the presence of baseline cardiovascular comorbidities.</div></div><div><h3>Results</h3><div>The study population consisted of 4622 male adults 66 years of age and older diagnosed with mCRPC, of which 2430 initiated abiraterone and 2192 enzalutamide. The adjusted three-year overall survival was lower in patients initiating abiraterone (27.9 %) than enzalutamide (31.5 %) (adjusted survival difference [aSD] = −3.6 %, 95 % CI: −6.2 %, −0.9 %). In frailty-stratified analysis, no survival difference was found for the robust (aSD = 0.6 %, 95 % CI: −5.0 %, 6.3 %) or frail (aSD = −1.2 %, 95 % CI: −6.1 %, 3.7 %) subgroups, but there was lower survival with abiraterone for the prefrail group (aSD = −5.9 %, 95 % CI: −9.6, −2.3). The adjusted one-year risk of MACE was higher in abiraterone initiators (5.5 %) than enzalutamide initiators (3.6 %) (adjusted risk difference [aRD] = 1.8 %, 95 % CI: 0.6 %, 3.1 %); the increase was significant in the frail (aRD = 4.8 %, 95 % CI = 1.4 %, 8.3 %) and pre-frail subgroups (aRD =1.9 %, 95 % CI: 0.1 %, 3.6 %) but not the robust subgroup (aRD = −0.3 %, 95 % CI: −1.8 %, 1.2 %).</div></div><div><h3>Discussion</h3><div>The three-year survival of abiraterone initiators was slightly lower than that of enzalutamide initiators, though the agents showed similar survival for patients with robust fitness. A one-year increase in MACE risk was observed in abiraterone initiators, especially amongst frail individuals, highlighting the importance of assessing frailty during therapy selection.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102148"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}