Less Chemotherapy, Fewer Falls, Personalized Care: Study Reinforces Major Strides in Geriatric Oncology

In In The News by Barbara Jacoby

From: PR Newswire

Doctors can safely lower the dose of cancer treatment such as chemotherapy without impacting survival for adults older than 70 who are at high risk for toxic side effects. The results are from a potentially practice-changing new study, published in The Lancet, and led by a Wilmot Cancer Institute scientist at the University of Rochester Medical Center.

Oncologists have been fearful of deviating from standard guidelines for cancer treatment. But the new study proves that more personalized care can be delivered safely to older adults, based on their medical histories and individual circumstances.

The randomized clinical trial involved 718 patients with a mean age of 72, who had advanced cancer and other aging-related conditions. Results show that patients who received a geriatric assessment (GA) benefited from less serious side effects, fewer falls, and other favorable medication changes that protected their overall health. The Lancet data adds to a growing collection of geriatric oncology research addressing the most effective ways to treat the oldest people facing cancer.

“Giving oncologists an evidence-based tool that allows them to make adjustments based on a patient’s fitness is very powerful and an excellent step forward in cancer care delivery,” said Supriya Mohile, M.D., M.S., the Philip and Marilyn Wehrheim professor of Medicine, Hematology/Oncology and Surgery at URMC and a Wilmot research program leader. She is the corresponding and first author of The Lancet article, and has been an award-winning national leader in geriatric oncology, helping to establish new guidelines for the use of geriatric assessments put forth by the American Society of Clinical Oncology (ASCO).

A GA gives oncologists a fuller picture of the patient, measuring the impact of other medical conditions (diabetes, for example), physical and mental functionality, and the level of family and social support. The assessment, which is recommended by ASCO, can guide decisions about treatment and dosing and improve communication, but is not used as frequently as suggested. Researchers believe the new study will boost its usage across the country.

Investigators were able to reach a broad sample of patients by leveraging Wilmot’s position as a hub for the National Community Oncology Research Program or NCORP, a network of cancer providers at more than 1,000 NCORP-affiliated clinics in 44 states. Aging is the biggest risk factor for cancer, and yet older adults have been historically underrepresented in cancer clinical trials. The study noted that 60 percent of all cancers and 70 percent of all cancer deaths occur in older adults — elevating the importance of geriatric oncology research.