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How to Optimize Cancer Treatment in Older Patients

An Overview of Available Geriatric Tools

Pamoukdjian, Frédéric, MD*,†; Liuu, Evelyne, MD; Caillet, Philippe, MD†,§; Herbaud, Stéphane, MD; Gisselbrecht, Mathilde, MD§; Poisson, Johanne, MD§; Boudou-Rouquette, Pascaline, MD; Zelek, Laurent, MD#; Paillaud, Elena, MD, PhD†,§

American Journal of Clinical Oncology: February 2019 - Volume 42 - Issue 2 - p 109–116
doi: 10.1097/COC.0000000000000488
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Cancer is a disease of older people, but this age group has often been excluded from clinical trials of cancer, which leads to poor transportability of standardized treatments in older cancer patients. One of the main reasons for the exclusion is the heterogeneity of older people in several domains: social environment, comorbidities, dependency, functional status, nutritional status, cognition status, and mood status. Comprehensive geriatric assessment aims to assess this heterogeneity and has identified frequent health problems often unknown before therapeutic decisions, which allows for targeted geriatric interventions with or without follow-up and appropriate cancer treatment selection. Several tools and scores have been developed for a complementary approach. These tools have the following characteristics: they screen for vulnerability to select patients who may benefit from a comprehensive geriatric assessment; are predictive tools for survival, postoperative complications, or chemotherapy-related toxicity; are decisional algorithms for cancer treatment; or define a core set of geriatric data to be collected in clinical cancer trials. Here, we present an overview of the geriatric tools that were published in PubMed from 2000 to 2017, that could help in the therapeutic decision-making for older cancer patients.

*APHP, Avicenne Hospital, Department of Geriatric Medicine, Coordination Unit of Geriatric Oncology

#APHP, Avicenne Hospital, Department of Medical Oncology, Bobigny

University Paris-Est, UPEC, DHU A-TVB, IMRB-EA 7376 CEpiA (Clinical Epidemiology and Ageing Unit)

APHP, Henri Mondor Hospital, Department of Geriatric, Creteil

Department of Geriatric, Universitary Hospital of Poitiers, Poitiers

§APHP, Europeen Georges Pompidou Hospital, Department of Geriatric Medicine, Geriatric Oncology Unit

APHP, Cochin Hospital, Department of Oncology, Paris, France

The authors declare no conflicts of interest.

Reprints: Frédéric Pamoukdjian, MD, APHP, Avicenne Hospital, Department of Geriatric Medicine, Coordination Unit of Geriatric Oncology, Bobigny F93000, France. E-mail: frederic.pamoukdjian@aphp.fr.

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