Correspondence: Where Are We Headed With Research in Frail Elderly Patients With Cancer?

Where Are We Headed With Research in Frail Elderly Patients With Cancer?

 We should ask ourselves two key questions: Are we properly identifying the frail elderly patient with cancer who comes to our consulting rooms? And do we have sufficient scientific evidence to decide whether to treat this patient with chemotherapy? If we want to treat this population group to the best of our ability, we should be able to answer these questions.

 To the Editor:
The article by Corre et al¹ described the ESOGIA (Elderly Selection on Geriatric Index Assessment) trial that was carried out in French and Spanish hospitals and that included elderly patients age 70 years or older with advanced non–small-cell lung cancer. The article provides hitherto unpublished information about the ability of a comprehensive geriatric assessment (CGA) to classify elderly patients with cancer and about its usefulness in decision making in this age group. CGA has already demonstrated its superiority in evaluating the elderly by providing more information than simply the patient’s performance status² and by giving a more reliable prediction of the risk of toxicity with chemotherapy.^3,4 In addition, different components of the CGA have independently demonstrated its ability to predict the toxicity of chemotherapy.^3-5 Recently, the oncological-multidimensional prognostic index (Onco-MPI), which is based on the CGA, has proved to be a good predictive tool for 1-year mortality in older patients with cancer.⁶ Despite many relevant advances, it seems that not all of the efforts to reach a specific and definitive conclusion with regard to selecting treatment for elderly patients with cancer are heading in the same direction.....

REFERENCES

1. 1.↵
   
   

   1. Corre R,
   2. Greillier L,
   3. Le Caër H,
   4. et al.

   (2016) Use of a comprehensive geriatric assessment for the management of elderly patients with advanced non–small-cell lung cancer: The phase III randomized ESOGIA-GFPC-GECP 08-02 study. J Clin Oncol 34:1476–1483.

   
   

   Abstract/FREE Full Text
   
2. 2.↵
   1. Repetto L,
   2. Fratino L,
   3. Audisio RA,
   4. et al.

   (2002) Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: An Italian Group for Geriatric Oncology Study. J Clin Oncol 20:494–502.

   Abstract/FREE Full Text
3. 3.↵
   1. Hurria A,
   2. Togawa K,
   3. Mohile SG,
   4. et al.

   (2011) Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study. J Clin Oncol 29:3457–3465.

   Abstract/FREE Full Text
4. 4.↵
   1. Extermann M,
   2. Boler I,
   3. Reich RR,
   4. et al.

   (2012) Predicting the risk of chemotherapy toxicity in older patients: The Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer 118:3377–3386.

   CrossRefMedlineGoogle Scholar

5. 5.↵
   1. Aaldriks AA,
   2. Maartense E,
   3. le Cessie S,
   4. et al.

   (2011) Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy. Crit Rev Oncol Hematol 79:205–212.

   CrossRefMedlineGoogle Scholar
6. 6.↵
   1. Brunello A,
   2. Fontana A,
   3. Zafferri V,
   4. et al.

   (2016) Development of an oncological-multidimensional prognostic index (Onco-MPI) for mortality prediction in older cancer patients. J Cancer Res Clin Oncol 142:1069–1077.

   CrossRefMedlineGoogle Scholar
7. 7.↵
   1. Balducci L,
   2. Extermann M

   (2000) Management of cancer in the older person: A practical approach. Oncologist 5:224–237.

   Abstract/FREE Full Text
8. 8.↵
   1. Droz JP,
   2. Efstathiou E,
   3. Yildirim A,
   4. et al.

   (2016) First-line treatment in senior adults with metastatic castration-resistant prostate cancer: A prospective international registry. Urol Oncol 34:234.e21–234.e29.

   CrossRefGoogle Scholar
9. 9.↵
   1. Handforth C,
   2. Clegg A,
   3. Young C,
   4. et al.

   (2015) The prevalence and outcomes of frailty in older cancer patients: A systematic review. Ann Oncol 26:1091–1101.

   Abstract/FREE Full Text
10. 10.↵
    1. Xue QL

    (2011) The frailty syndrome: Definition and natural history. Clin Geriatr Med 27:1–15.

    CrossRefMedlineGoogle Scholar

Related Articles

• CORRESPONDENCE: Comprehensive Geriatric Assessment-Guided Therapy Does Improve Outcomes of Older Patients With Advanced Lung Cancer
  

  • Ajeet Gajra,
  • Kah Pah Loh,
  • Arti Hurria,
  • Hyman Muss,
  • Ron Maggiore,
  • William Dale,
  • Heidi D. Klepin,
  • Allison Magnuson,
  • Stuart M. Lichtman,
  • Grant R. Williams,
  • Armin Shahrokhni,
  • and Supriya G. Mohile

  JCO JCO675926; published online on August 22, 2016;
  • [Full Text]
  • [PDF]
• CORRESPONDENCE: Reply to R.D. Nipp et al, M.-J. Molina-Garrido et al, and A. Gajra et al
  

  • Romain Corre,
  • Hervé Léna,
  • Alain Vergnenègre,
  • and Christos Chouaïd

  JCO JCO691105; published online on August 22, 2016;
  • [Full Text]
  • [PDF]
• CORRESPONDENCE: Small Step for Geriatric Oncology That Could Have Been a Giant Leap
  

  • Ryan D. Nipp and
  • Gregory A. Abel

  JCO JCO690446; published online on August 22, 2016;