Journal of geriatric oncology最新文献

{"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}

{"title":"Technology ownership, use, and perceptions of web-based program design features for older adults prescribed oral anticancer medication","authors":"Victoria K. Marshall ,&nbsp;Melody N. Chavez ,&nbsp;Tina M. Mason ,&nbsp;Martine Extermann ,&nbsp;Lanie A. Simon ,&nbsp;Jay Ligatti ,&nbsp;Usha Menon ,&nbsp;Laura A. Szalacha","doi":"10.1016/j.jgo.2025.102190","DOIUrl":"10.1016/j.jgo.2025.102190","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults are often prescribed oral anticancer agents (OAAs). Technology-based interventions may offer medication and symptom support. We aimed to evaluate technology ownership, use, and preferred design features of a supportive web-based program using a multimethod design utilizing surveys and semi-structured interviews.</div></div><div><h3>Materials and Methods</h3><div>Patients were recruited from a National Cancer Institute-designated Comprehensive Cancer Center. Eligibility included those: (1) ≥65 years of age; (2) prescribed a Food and Drug Administration-approved OAA; (3) English speaking; (4) able/willing to complete telephone interviews. Interviews were audio-recorded and transcribed verbatim. Cohen's Kappa was used to evaluate inter-rater reliability and calculated at 0.87.</div></div><div><h3>Results</h3><div>Participants (<em>N</em> = 30) were predominantly female (70 %), White (83.3 %), with metastatic disease (90 %). The mean age was 74.9 years. Ninety percent owned a smartphone, 66.7 % owned a tablet, and 90 % owned a computer. Nearly 57 % reported using smartphones frequently for cancer-related purposes. Four themes with corresponding subthemes were identified: (1) comfort with technology; (2) reasons for technology use for health-related purposes (research of cancer, cancer treatment, and related symptoms/side effects; using the portal to manage health; and appointment and medication reminders); (3) recommended design features for a web-based program (OAA medication-specific information; calendars &amp; medication alarms/reminders; symptom management &amp; symptom trackers; and tutorials and testimonials); and (4) adaptations for older adults (simple navigation; larger font; use of layperson's terms; use of pictures, graphics, and color coding; and voice activation).</div></div><div><h3>Discussion</h3><div>Older adults use technology for health-related purposes. Specific web-design features and adaptations are needed to enhance usability among older adults.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102190"},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006701","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 outcomes in older patients presenting to a radiation oncology clinic based on an electronic health record-based frailty index.","authors":"Ryan T Hughes, Niema B Razavian, Claire M Lanier, Michael K Farris","doi":"10.1016/j.jgo.2025.102192","DOIUrl":"10.1016/j.jgo.2025.102192","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102192"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006711","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":"Compounding strain: The impact of caregiver strain on health outcomes in older adults with new cancer diagnoses","authors":"Jamie M. Smith ,&nbsp;Bian Liu ,&nbsp;J. Nicholas Odom ,&nbsp;Katherine A. Ornstein ,&nbsp;Erin E. Kent","doi":"10.1016/j.jgo.2025.102191","DOIUrl":"10.1016/j.jgo.2025.102191","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to examine the association between pre-existing caregiving strain levels and care recipient health outcomes following a new cancer diagnosis.</div></div><div><h3>Materials and Methods</h3><div>We used the National Health and Aging Trends Study (NHATS) linked with the National Study of Caregiving (NSOC) and Medicare claims to identify older adults receiving family caregiving within one year before an index cancer diagnosis. Caregiving strain was determined using NSOC items of self-reported emotional, physical, and financial difficulties measured before the cancer diagnosis. We used care recipient NHATS responses to determine outcomes with the Patient Health Questionnaire-2 (PHQ-2), Generalized Anxiety Disorder Scale (GAD-2), and self-reported general health pre and post-cancer diagnoses. Multivariable logistic regression models were used to examine care recipient's health outcomes following cancer diagnosis by previously existing caregiver strain levels.</div></div><div><h3>Results</h3><div>We identified 584 caregivers who had completed the NSOC items related to caregiving strain and were linked to 404 care recipients whose index cancer diagnoses occurred in the year following the NSOC interview. Care recipients with highly strained caregivers were more likely to report anxiety than recipients with less strained caregivers (33.5 % vs. 22.9 %, <em>p</em> &lt; 0.05). In adjusted models, high strain was associated with increased odds of recipient anxiety (aOR: 2.08, 95 % CI 1.14–3.79). Depressive symptoms and general health outcomes did not differ by caregiver strain in adjusted models.</div></div><div><h3>Discussion</h3><div>The presence of caregiver strain may contribute to worsening care recipient anxiety following a new cancer diagnosis. Strategically placed caregiver screenings early in the cancer care planning could identify strained caregivers who may benefit from targeted support and training. and support.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102191"},"PeriodicalIF":3.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006650","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":"Characteristics of older patients undergoing major oncological surgery: Insights from the Geriatric Surgery Verification Program","authors":"Omid Salehi ,&nbsp;Irving Zhao ,&nbsp;Joanna Abi Chebl ,&nbsp;Ponnandai Somasundar ,&nbsp;Lidia Vognar ,&nbsp;N. Joseph Espat ,&nbsp;Abdul Saied Calvino ,&nbsp;Steve Kwon","doi":"10.1016/j.jgo.2025.102189","DOIUrl":"10.1016/j.jgo.2025.102189","url":null,"abstract":"<div><h3>Introduction</h3><div>Studies outlining the unique burden of geriatric medical conditions and syndromes among older adults undergoing major oncological surgery are lacking, along with understanding of the goals of care for this population.</div></div><div><h3>Materials and Methods</h3><div>We conducted a single-institutional review of the initial 50 patients who enrolled in the American College of Surgeons' Geriatric Surgery Verification Program (GSV) program implemented for those ≥65 years undergoing major oncological surgery during the year 2023. Patient variables were categorized into four domains - somatic, functional, psychological, and social. The impact of GSV was analyzed by comparing the GSV cohort to historical controls from 2021 using patients' goals of care as the outcome of interest.</div></div><div><h3>Results</h3><div>The mean age of participants was 75.4 years (± 7.5). They were mostly White (72 %), English-speaking (78 %), with similar distribution of sex (54 % female). In the somatic category, nearly 40 % were at moderate to high nutrition risk and 61.5 % had a Geriatric 8 score of ≤14. In the functional category, 34.7 % used a cane or walker, 6.4 % had history of falls, and 22.4 % had some degree of frailty. In the psychological category, &gt;70 % reported some degree of depression. Delirium risk factors were identified in 43 % of the patients. In the social category, more than half (54.3 %) of patients were never married, widowed, or divorced. Financial distress screening was positive in 23.3 %. In regard to goals of care, most patients (79.3 %) reported wanting to maintain independence while only 37.9 % reported extending life as primary concern. Using a composite adverse outcome (CAE) variable incorporating 30-day mortality and institutionalization 30-days after discharge as surrogate for these goals, we found that GSV group had an 8.0 % 30-day CAE rate compared to 28.9 % in the historical controls (<em>p</em> = 0.01).</div></div><div><h3>Discussion</h3><div>We found high proportions of patients with low G8 score, frailty, perioperative risk of falls and delirium, lack of social support, and financial distress. To meet the care goals of this population, a comprehensive geriatric surgery program is essential to preoperatively capture and mitigate risk factors.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102189"},"PeriodicalIF":3.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006687","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":"Association of age and performance status with adverse events in older adults with diffuse large B-cell lymphoma receiving frontline R-CHOP therapy: Alliance 151930, a secondary analysis of the phase III trial CALGB 50303","authors":"Vicki A. Morrison ,&nbsp;Jennifer Le-Rademacher ,&nbsp;Olivia Bobek ,&nbsp;Daniel Satele ,&nbsp;John P. Leonard ,&nbsp;Aminah Jatoi","doi":"10.1016/j.jgo.2025.102185","DOIUrl":"10.1016/j.jgo.2025.102185","url":null,"abstract":"<div><h3>Introduction</h3><div>Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) therapy is the standard of care for patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). However, detailed delineation of toxicity data is limited and has not been examined by age. We sought to examine adverse event data in patients receiving R-CHOP from the Cancer and Leukemia Group B (CALGB) 50303 trial to determine if there were differences in grade 3+ toxicities by age cohort or ECOG performance status (PS), and if outcome was impacted by age cohort or toxicity occurrence.</div></div><div><h3>Materials and Methods</h3><div>CALGB 50303 was an intergroup phase III study for previously untreated patients with DLBCL that included R-CHOP as one of the trial arms. In the subset of 235 evaluable, seemingly fit patients receiving R-CHOP on this trial, data regarding the occurrence of grade 3+ hematologic and non-hematologic toxicities by treatment arm, as well as completion of protocol therapy, overall response rate (ORR), and survival outcome parameters were collected and analyzed for Alliance A151930.</div></div><div><h3>Results</h3><div>Data were available for further analysis from 235 of 243 patients evaluable for safety, i.e., those who received R-CHOP therapy on this trial, with 165 being &lt;65 years of age, and 70 ≥ 65 years of age. There was an increased rate of grade 3+ non-hematologic (but not hematologic) toxicities in the older age cohorts, after controlling for disease stage and performance status (<em>p</em> &lt; 0.001). One-year and three-year overall survival (OS) were inferior in patients ≥65 years of age, compared to those &lt;65 years of age; there was no difference in one-year or in three-year progression-free survival (PFS) between the age cohorts.</div></div><div><h3>Discussion</h3><div>Standard frontline therapy with R-CHOP can be effectively administered to an older age cohort. We found more grade 3+ non-hematologic, but not hematologic, toxicities in older patients. These data can be used in clinical trial and real-world settings to identify at-risk DLBCL subgroups for which pro-active measures can be utilized to ensure completion of therapy and optimization of clinical outcomes.</div><div><span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> Identifier: <span><span>NCT00118209</span><svg><path></path></svg></span> (CALGB 50303).</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102185"},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983786","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":"Relevance of diabetes mellitus as a confounding variable in chemotherapy outcomes","authors":"Amir Reza Akbari ,&nbsp;Benyamin Alam","doi":"10.1016/j.jgo.2025.102188","DOIUrl":"10.1016/j.jgo.2025.102188","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102188"},"PeriodicalIF":3.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983122","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":"Increasing the evidence for comprehensive geriatric assessment – Outlook on another work in progress","authors":"Miriam Hüttmeyer ,&nbsp;Kathrin Tatschner ,&nbsp;Elisabeth Jentschke ,&nbsp;Carmen Roch ,&nbsp;Barbara Deschler-Baier","doi":"10.1016/j.jgo.2024.102078","DOIUrl":"10.1016/j.jgo.2024.102078","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 2","pages":"Article 102078"},"PeriodicalIF":3.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978820","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":"Exploring the status of online social support for older adults with cancer: A scoping review.","authors":"Fei Liu, Sophie Pilleron, India Pinker","doi":"10.1016/j.jgo.2024.102182","DOIUrl":"https://doi.org/10.1016/j.jgo.2024.102182","url":null,"abstract":"<p><strong>Introduction: </strong>The number of new cancer cases among older adults is rising, yet their social support needs remain unmet due to diminishing social networks with age. Since the COVID-19 pandemic, online technologies have provided increased opportunities for social support for this demographic via digital platforms such as online peer support groups, online communities, and chat rooms. This scoping review explores the current state of the use of online social support for older adults with cancer.</p><p><strong>Materials and methods: </strong>This scoping review was based on the Arksey and O'Malley methodological framework with the extension proposed by Levac and colleagues. The protocol was registered on Open Science Framework (OSF). PubMed, Elsevier Embase (including Medline), and EBSCO CINAHL Complete were searched to identify eligible studies. The review findings were presented in a narrative synthesis.</p><p><strong>Results: </strong>Out of 6542 references, we included three studies. Two studies investigated older patients' preferences for different types of peer support through surveys and questionnaires, and the third examined the feasibility of an online platform for older women with breast cancer. Barriers identified include a lower interest and familiarity, sense of involvement, and emotional impact of a new diagnosis. However, factors such as socio-demographic characteristics and positive motivation for using online peer support act as facilitators.</p><p><strong>Discussion: </strong>This scoping review is the first to examine the literature on online social support specifically for older adults with cancer, revealing a paucity of research. Further research is required to understand the potential need and interest in online social support for this population, especially as technology becomes more integrated into daily life post-COVID.</p>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102182"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965563","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":"Three lessons from \"The Fox and the Grapes\" to inform precision oncology in the older adult.","authors":"Gabriel Aleixo, Teja Voruganti, Ramy Sedhom","doi":"10.1016/j.jgo.2025.102186","DOIUrl":"https://doi.org/10.1016/j.jgo.2025.102186","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102186"},"PeriodicalIF":3.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965565","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}