Elderly CAncer Patient

Conditions

Hematologic Malignancies, Solid Cancer

Keywords

Elderly, Cancer, Geriatric assessment, Treatment, Epidemiology

Brief summary

The management of older patients with cancer has become a major public health concern in Western countries because of the aging of the population and steady increase in cancer incidence with advancing age. Cancer treatment of aged patients is complex due to comorbidities, polypharmacy and functional status. The heterogeneity of the older population in terms of comorbidities and functional status may explain the difficulty in establishing management recommendations. Study hypothesis is that a geriatric consultation using Geriatric Assessment (GA) can evaluate patient's resource and strengths, in order to help oncologist to define the most effective treatment. The GA developed by geriatricians and recommended by the International Society of Geriatric Oncology (SIOG), is a multidimensional assessment of general health status; comorbidities; functional status; nutritional, cognitive, psychological, and social parameters; and medications. The GA uses validated geriatric scales to produce an inventory of problems, which can then serve to develop an individualized geriatric intervention plan; it may be an important step in selecting elderly patients for cancer screening and treatment. The objectives are: * To assess the role of GA for decision making process for older patients with cancer * To identify geriatric and oncologic factors associated with overall survival, treatment feasibility, toxicities, morbidities * To develop and/or validate screening tests for frailty in geriatric oncology * To develop and validate frailty classifications Method: The ELCAPA (ELderly CAncer PAtient) survey is a French multicentric prospective study that includes all patients age 70 years or older who has a diagnosis of solid cancer or hematologic malignancies in French hospitals

A. Serrano, Marie Laurent, Thomas Barnay, Claudia Martinez‐Tapia, Étienne Audureau et al. (13 authors)

Journal of Clinical Oncology2022-10-2814 citations

10.1200/jco.22.01118

A decision curve analysis of the clinical usefulness of a two-step frailty assessment strategy in older patients with prostate, breast, colorectal, or lung cancer.

A. Serrano, Marie Laurent, Thomas Barnay, Claudia Martinez‐Tapia, Étienne Audureau et al. (13 authors)

Journal of Clinical Oncology2022-06-011 citations

10.1200/jco.2022.40.16_suppl.12011

The obesity paradox for mid- and long-term mortality in older cancer patients: a prospective multicenter cohort study.

Martinez-Tapia C, Diot T, Oubaya N, Paillaud E, Poisson J, Gisselbrecht M, Morisset L, Caillet P, Baudin A, Pamoukdjian F, Broussier A, Bastuji-Garin S, Laurent M, Canouï-Poitrine F.

2020-09-0516 citations

10.1093/ajcn/nqaa238

Using machine learning to predict mortality in older patients with cancer: Decision tree and random forest analyses from the ELCAPA and ONCODAGE prospective cohorts.

Étienne Audureau, Pierre Soubeyran, Claudia Martinez‐Tapia, Carine Bellera, Sylvie Bastuji‐Garin et al. (13 authors)

Journal of Clinical Oncology2019-05-203 citations

10.1200/jco.2019.37.15_suppl.11516

Cancer-specific mortality and competing causes of death in older adults: A prospective, multicenter cohort study (ELCAPA-19).

Déborah Assouan, Éléna Paillaud, Philippe Caillet, Emmanuelle Kempf, H. Vincent et al. (14 authors)

Journal of Clinical Oncology2019-05-202 citations

10.1200/jco.2019.37.15_suppl.11547

Obesity paradox in older cancer patients for middle and long-term mortality: A prospective multicenter cohort study of 2,071 patients.

Claudia Martinez‐Tapia, Thomas Diot, Nadia Oubaya, Éléna Paillaud, Johanne Poisson et al. (12 authors)

Journal of Clinical Oncology2019-05-201 citations

10.1200/jco.2019.37.15_suppl.11555

Modeling causal associations between frailty components and mortality in older patients with cancer: A structural equation approach.

Florence Canouï‐Poitrine, Claudia Martinez‐Tapia, Frédéric Pamoukdjian, Simone Mathoulin‐Pélissier, Matthieu Frasca et al. (12 authors)

Journal of Clinical Oncology2019-05-20

10.1200/jco.2019.37.15_suppl.e23021

Interventions

OTHERExtensive GA

GA includes an evaluation of nine domains according to international recommendations : * functional status (six-item Activities of Daily Living (ADL) score, Instrumental Activities of Daily Living (IADL)) * mobility (timed get-up-and-go test, one-leg standing balance test, history of fall) * nutritional status (French National Authority of Health guidelines, weight loss body mass index (BMI), Mini Nutritional Assessment, albumin ) * cognitive status (Mini-Mental State Examination (MMSE), history of dementia, confusion) * mood (Mini-Geriatric Depression Scale (Mini-GDS), symptoms of anxiety, depression (DSM V)) * comorbidities (CIRS G) * polypharmacy (number of medications) * social environment (primary caregiver, support at home, friends , family, living alone) * urinary and/or fecal incontinence

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

70 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Patient aged 70 years or older * Diagnosed cancer at all stage * Referred to a geriatrician for GA * Given oral non-opposition from patient or a legally mandated person

Exclusion criteria

* Oral opposition

Design outcomes

Primary

Measure	Time frame
Difference between initial oncologist treatment proposal and final treatment selected after geriatric assessment	through multidisciplinary meeting decision, an average of 2 weeks after GA (+/-1 week).

Secondary

Measure	Time frame
Chemotherapy toxicities using Common Terminology Criteria for Adverse Events	through chemotherapy treatment completion, an average of 6-months after inclusion (+/- 3 months) (according to curative or palliative and chemotherapy protocols).
Feasibility of the planned Chemotherapy treatment (delivery of the planned number of cycles determined based on tumor site and metastatic status)	through chemotherapy treatment completion, an average of 6-months after inclusion (+/- 3 months) (according to curative ou palliative and chemotherapy protocols).
Overall mortality	Year 1 and 5 years follow-up

Countries

France

Contacts

Primary ContactPHILIPPE CAILLET, MD

philippe.caillet@aphp.fr(0)149814707

Outcome results

None listed