Journal of geriatric oncology最新文献

{"title":"Geriatric prehabilitation prior to surgery for kidney tumors: Study protocol for Pre-KiT - A randomized controlled trial","authors":"Marie Juul-Haslund ,&nbsp;Cecilia M. Lund ,&nbsp;Troels G. Dolin ,&nbsp;Katrine Schou-Jensen ,&nbsp;Peter B. Østergren ,&nbsp;Anders Vinther ,&nbsp;Frederik F. Thomsen ,&nbsp;Mikkel Fode","doi":"10.1016/j.jgo.2026.102893","DOIUrl":"10.1016/j.jgo.2026.102893","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) primarily affects older adults who often present with frailty, increasing their risk of surgical complications and delayed recovery. Prehabilitation, incorporating exercise, nutrition, and psychological support, may improve postoperative outcomes. However, no studies have investigated prehabilitation prior to surgery for RCC. The aim is to assess whether a one-month multimodal prehabilitation program including geriatric interventions improves recovery in patients with frailty undergoing surgery for localized RCC ≤ 7 cm.</div></div><div><h3>Materials and methods</h3><div>60 patients, aged ≥65, with a Clinical Frailty Scale (CFS) score of 3–6 are randomized 1:1 to standard care or prehabilitation involving home-based exercise, geriatric assessment with tailored interventions, and smoking cessation support. The primary outcome is change in Quality of Recovery-15 (QoR-15) 21 days postoperatively. Secondary outcomes include changes in QoR-15, health-related quality of life (EQ-5D-5L) and physical performance (30-s chair-stand test, handgrip strength) assessed preoperatively, 1, 21 and 90 days postoperatively. Postoperative complications will be evaluated using the Clavien-Dindo classification, alongside a cost-effectiveness analysis. Long-term outcomes include 1- and 5-year recurrence-free, cancer-specific, and overall survival.</div></div><div><h3>Discussion</h3><div>Pre-KiT explores if a pragmatic geriatric prehabilitation strategy is effective and feasible for older frail patients with RCC. The intervention is designed for easy implementation in clinical practice: administered by a single healthcare professional, requiring only one additional hospital visit, and consists of home-based exercises. This low-resource approach also aims to minimize financial costs, which is of importance for implementation possibilities. If successful, it could improve standard care and outcomes after surgery.</div><div><em>Trial registration</em>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> ID: <span><span>NCT06745609</span><svg><path></path></svg></span>. Prospectively registered December 12th, 2024.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102893"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064167","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":"Management of surgically resectable colorectal liver metastases in older patients","authors":"Sara Myers ,&nbsp;Ponnandai Somasundar ,&nbsp;Clark DuMontier ,&nbsp;Dae Hyun Kim ,&nbsp;Steve Kwon","doi":"10.1016/j.jgo.2025.102840","DOIUrl":"10.1016/j.jgo.2025.102840","url":null,"abstract":"<div><div>Surgical resection offers a curative treatment option for patients with colorectal cancer liver metastases (CRLM), but data on resection of CRLM among older patients is conflicting and sparse. The older population is heterogenous, and no age-calibrated guidelines for management of surgically resectable CRLM exist. Age-related physiologic changes to the liver include impaired tissue growth, increased oxidative stress and inflammation, and dysregulated metabolic homeostasis. Cumulatively, these changes to the liver microenvironment lead to decreased regeneration ability of the liver and higher vulnerability to the stress of surgery. Systemic chemotherapy may also be associated with worse hepatotoxicity among older patients. Given the combination of age-related physiological changes and chemotherapy-associated hepatotoxicity, evaluating both the volume and the function of the future liver remnant (FLR) among older patients is critically important. Additionally, older patients may have higher risks for both medical and surgical postoperative complications including following CRLM resection. Liver-directed therapy, including transarterial chemoembolization (TACE), transarterial delivery of irinotecan-coated beads (DEBIRI), hepatic infusion chemotherapy (HAI), as well as radiation and ablation therapy are well-tolerated and may be offered to older patients. Discussions of CRLM resection and treatment options should be paired with goals of care conversations for older patients, including wishes surrounding both quantity and quality of life, and functional outcomes. Some older patients, including frail individuals or those with limited life expectancies, may benefit more from liver-directed therapy than from surgical management of CRLM. Shared-decision making tools may be helpful for discussing potential post-operative issues with older patients, including quality-adjusted life expectancy, the potential for loss of independent living, and stays in long-term care facilities following CRLM resection in addition to morbidity and mortality.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102840"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788098","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":"Effect of geriatric co-management on independence, quality of life, and severe toxicity in vulnerable older patients with cancer: Results of a randomized clinical trial","authors":"Gabriele Ihorst ,&nbsp;Elisabeth Jentschke ,&nbsp;Kathrin Tatschner ,&nbsp;Carmen Roch ,&nbsp;Birgitt van Oorschot ,&nbsp;Peter Baier ,&nbsp;Bernhard Geyer ,&nbsp;Miriam Hüttmeyer ,&nbsp;Christoph Hohlbein ,&nbsp;Anna Heckers ,&nbsp;Johanna Gerber ,&nbsp;Barbara Deschler-Baier","doi":"10.1016/j.jgo.2026.102896","DOIUrl":"10.1016/j.jgo.2026.102896","url":null,"abstract":"<div><h3>Introduction</h3><div>Cancer treatment puts older adults with cancer at increased risk for functional decline, impaired quality of life (QOL), and treatment-related toxicity. Geriatric co-management has been proposed as a strategy to improve outcomes in this vulnerable population.</div></div><div><h3>Materials and methods</h3><div>This prospective, randomized (1:1) trial evaluated the impact of geriatric co-management and intervention in patients aged ≥70 years with a G8 score &lt; 15 initiating new systemic outpatient treatment. The aim was to assess the efficacy of targeted interventions versus standard care. Two primary endpoints were chosen: independence (no restrictions in instrumental activities of daily living (IADL)) and QOL (global health scale of the European Organisation for the Research and Treatment of Cancer questionnaire: EORTC QLQ-C30) at 12 weeks (T2). Secondary endpoint was “incidence of severe adverse events” (Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0, grade ≥ 3). A multiprofessional team performed the geriatric assessment and co-management in the intervention group (IG).</div></div><div><h3>Results</h3><div>A total of 217 patients were enrolled (207 in full analysis set; median age 75 (range 70–89) years; 42% female). For both primary endpoints, a tendency for improvement in the IG was observed: an adjusted odds ratio (OR) of 1.34 (97.5% CI 0.60–2.98; <em>p</em> = 0.42) for regaining independence, and an adjusted difference in global QOL T2 scores of 1.82 (CI -4.44-8.07; <em>p</em> = 0.51). Statistical significance could not be demonstrated. Geriatric co-management reduced grade ≥ 3 toxicities compared with standard care (15.5% vs 30.8% of patients, risk difference − 15.2%, 95% CI -26.5%; −3.9%) and lowered unplanned hospitalizations (21.4% vs 28.8% of patients, risk difference − 7.5%, 95% CI -19.3%; 4.3%).</div></div><div><h3>Discussion</h3><div>The interventions showed a consistent, yet statistically insignificant, impact on quality of life and independence. Importantly, it was associated with a reduction in severe toxicity and may have led to fewer unplanned hospitalizations. Findings support further integration of geriatric co-management into routine oncology care for older adults with cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102896"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125306","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":"Tolerability of immune checkpoint inhibitors for cancer treatment in frail, older patients","authors":"Rochelle Sheppard ,&nbsp;Christopher Anstey ,&nbsp;Leila Hanjani ,&nbsp;Rahul Ladwa ,&nbsp;Robin Berry ,&nbsp;James Fletcher ,&nbsp;Ruth Hubbard","doi":"10.1016/j.jgo.2025.102829","DOIUrl":"10.1016/j.jgo.2025.102829","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICIs) are increasingly used in older adults, but tolerability among frail patients remains uncertain. This study examined immune-related adverse events (irAEs) and treatment outcomes in frail and non-frail adults aged ≥65 years.</div></div><div><h3>Materials and methods</h3><div>A retrospective single-centre review was conducted at Princess Alexandra Hospital (Queensland, Australia) of patients aged ≥65 who commenced at least one cycle of ICI between December 2021 and July 2023. Frailty was assessed using the Australian 58-item Frailty Index (FI) (non-frail &lt;0.25, frail ≥0.25). The primary outcome was any irAE as defined by Common Terminology Criteria for Adverse Events (CTCAE v5). Secondary outcomes included treatment discontinuation, cycles, interruptions, and corticosteroid use. Univariable and multivariable logistic regression modelling was performed, adjusting for age, sex, cycles, tumour type, stage, concurrent therapy, and Eastern Cooperative Oncology Group Performance Status (ECOG-PS).</div></div><div><h3>Results</h3><div>Of 122 adults (mean age 75.8 years, 66.4 % male), 51 (41.8 %) were frail. Twenty patients were still receiving ICIs and had not yet completed treatment at last census, leaving 102 records with evaluable outcomes for the final modelling. Any irAE occurred in 53 non-frail adults (74.7 %) and 28 frail adults (54.9 %) (adjusted OR 0.41, 95 % CI 0.19–0.89, <em>p</em> = 0.02). Non-frail adults had more grade 1 events (62.0 % vs 43.1 %, <em>p</em> = 0.045) and skin-related events (48 % vs 27 %, p = 0.04). Grade ≥ 3 events occurred in 11.3 % non-frail vs 11.8 % frail (OR 1.10, 95 % CI 0.38–3.17). Early discontinuation was 60.6 % in non-frail vs 74.5 % in frail (OR 1.90, 95 % CI 0.86–4.19, <em>p</em> = 0.12). Median cycles were 10 (IQR 4–16) in non-frail vs 6 (IQR 4–11) in frail (<em>p</em> = 0.04).</div></div><div><h3>Discussion</h3><div>Frailty (FI ≥0.25) was associated with fewer irAEs, but frail adults received fewer cycles. These findings are exploratory and should be interpreted cautiously as differences in exposure likely confound toxicity comparisons; time-to-event analyses are warranted.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102829"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768229","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":"A literature review on hypothalamic–pituitary–adrenal (HPA) axis dysregulation in older adults with cancer: A missing link in predicting treatment toxicity?","authors":"Len De Nys","doi":"10.1016/j.jgo.2026.102854","DOIUrl":"10.1016/j.jgo.2026.102854","url":null,"abstract":"<div><div>Older adults with cancer face disproportionately high rates of severe treatment-related toxicities, yet current prediction tools rarely incorporate biomarkers that capture physiological resilience. The hypothalamic–pituitary–adrenal (HPA) axis—central to stress adaptation, immune regulation, and tissue repair—undergoes pronounced age-related alterations, including elevated basal cortisol, reduced dehydroepiandrosterone (DHEA) and its sulphate form DHEAS, and an increased cortisol:DHEA(S) ratio. These changes may impair immune function, delay recovery, and exacerbate vulnerability to treatment toxicity. This narrative review synthesizes mechanistic and clinical evidence linking HPA-axis dysregulation to treatment tolerance in geriatric oncology. Common patterns include blunted diurnal cortisol slopes, elevated evening cortisol, and low DHEA(S), which are associated with fatigue, functional decline, and reduced survival across cancer types. However, their predictive value for acute treatment toxicities remains underexplored due to methodological heterogeneity, lack of age-specific reference ranges, and absence from existing geriatric toxicity models. This review proposes a translational roadmap that prioritizes (1) standardization of salivary cortisol/DHEA(S) protocols; (2) prospective, age-stratified validation studies using standardized toxicity endpoints; (3) interventional testing of behavioral or pharmacological strategies to modulate HPA function; and (4) integration into oncology workflows and electronic decision-support tools. Incorporating endocrine biomarkers into risk prediction could refine treatment stratification, enable targeted supportive care, and ultimately improve outcomes for older patients with cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102854"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046851","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":"The impact of scheduling complexities and limited human resources in geriatric oncology research","authors":"L. Mitchell ,&nbsp;E. Ramsdale ,&nbsp;M. Mohammed ,&nbsp;S. Mohile ,&nbsp;A. Magnuson ,&nbsp;S. Kadambi ,&nbsp;A. Job ,&nbsp;S. Hryniv ,&nbsp;J. Lubes ,&nbsp;J. Cacciatore ,&nbsp;V. Vaddaraju ,&nbsp;J. Bauer","doi":"10.1016/j.jgo.2026.102861","DOIUrl":"10.1016/j.jgo.2026.102861","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102861"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448491","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":"HER2-low breast cancers in older women (³70 years): Biology and clinical outcome compared to younger patients (<70 years)","authors":"I. Tretter Alvarez de Arcaya ,&nbsp;B. Syed ,&nbsp;E. Rakha ,&nbsp;A. Green ,&nbsp;K.-L. Cheung ,&nbsp;R. Parks","doi":"10.1016/j.jgo.2026.102865","DOIUrl":"10.1016/j.jgo.2026.102865","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102865"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448496","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":"Representation of older adults in registrational trials associated with therapeutic approvals in follicular lymphoma","authors":"R. Juthani ,&nbsp;K. Pugh ,&nbsp;N.R. Neuendorff ,&nbsp;P. Torka","doi":"10.1016/j.jgo.2026.102872","DOIUrl":"10.1016/j.jgo.2026.102872","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102872"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448497","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":"First-line modified-FOLFIRI plus bevacizumab or panitumumab in older patients with metastatic colorectal cancer: Results of two parallel phase II trials from Hellenic Oncology Research Group","authors":"A. Karampeazis,&nbsp;L. Vamvakas,&nbsp;A. Kotsakis,&nbsp;N. Vardakis,&nbsp;E. Kontopodis,&nbsp;J. Souglakos,&nbsp;D. Chatzidaki,&nbsp;V. Georgoulias,&nbsp;Hellenic Oncology Research Group","doi":"10.1016/j.jgo.2026.102873","DOIUrl":"10.1016/j.jgo.2026.102873","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102873"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448498","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":"Feasibility and acceptability of a novel intervention to improve communication for older adults with dual diagnoses of dementia and cancer along with their care partners","authors":"A. Magnuson ,&nbsp;A. Job ,&nbsp;J. Bauer ,&nbsp;J. Mortimer ,&nbsp;E. Nguyen ,&nbsp;S. Hryniv ,&nbsp;H. D'Aurizio ,&nbsp;N. Dukelow ,&nbsp;L. Berkhof ,&nbsp;R. Gelb ,&nbsp;R. Epstein ,&nbsp;B. Kluger ,&nbsp;K. Heffner ,&nbsp;M. Sohn ,&nbsp;L. Wang ,&nbsp;E. Ramsdale ,&nbsp;S. Kadambi ,&nbsp;K.P. Loh ,&nbsp;M. Janelsins ,&nbsp;S. Mohile","doi":"10.1016/j.jgo.2026.102887","DOIUrl":"10.1016/j.jgo.2026.102887","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"17 2","pages":"Article 102887"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448611","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}