Adequate assessment yields appropriate care-the role of geriatric assessment and management in older adults with cancer: a position paper from the ESMO/SIOG Cancer in the Elderly Working Group

K P Loh; G Liposits; S P Arora; N R Neuendorff; F Gomes; J L Krok-Schoen; T Amaral; E Mariamidze; L Biganzoli; E Brain; C Baldini; N M L Battisti; M Frélaut; R Kanesvaran; A R A Mislang; D Papamichael; C Steer; S Rostoft

doi:10.1016/j.esmoop.2024.103657

Adequate assessment yields appropriate care-the role of geriatric assessment and management in older adults with cancer: a position paper from the ESMO/SIOG Cancer in the Elderly Working Group

ESMO Open. 2024 Aug;9(8):103657. doi: 10.1016/j.esmoop.2024.103657. Epub 2024 Aug 19.

Authors

K P Loh¹, G Liposits², S P Arora³, N R Neuendorff⁴, F Gomes⁵, J L Krok-Schoen⁶, T Amaral⁷, E Mariamidze⁸, L Biganzoli⁹, E Brain¹⁰, C Baldini¹¹, N M L Battisti¹², M Frélaut¹³, R Kanesvaran¹⁴, A R A Mislang¹⁵, D Papamichael¹⁶, C Steer¹⁷, S Rostoft¹⁸

Affiliations

¹ Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, USA. Electronic address: education@esmo.org.
² Department of Oncology, Odense University Hospital, Odense, Denmark. Electronic address: https://twitter.com/G_LipositsMD.
³ Division of Hematology/Oncology, Department of Medicine, Mays Cancer Center, University of Texas Health San Antonio, San Antonio, USA. Electronic address: https://twitter.com/DrSukeshiArora.
⁴ Department of Geriatrics, Marien Hospital Herne, University Hospital, Ruhr University Bochum, Herne, Germany. Electronic address: https://twitter.com/neuendorff_nr.
⁵ Medical Oncology Department, The Christie NHS Foundation Trust, Manchester; Senior Adult Oncology, The Christie NHS Foundation Trust, Manchester, UK. Electronic address: https://twitter.com/FabioGomes_go.
⁶ Comprehensive Cancer Center, The Ohio State University, Columbus; School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, USA. Electronic address: https://twitter.com/KrokSchoen.
⁷ Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany. Electronic address: https://twitter.com/TeeresaSAmaral.
⁸ Todua Clinic-Department of Oncology and Hematology, Tbilisi, Georgia; Ospedale Policlinico San Martino-Clinica di Oncologia Medica, Genoa. Electronic address: https://twitter.com/EMariamidze.
⁹ "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Prato, Italy.
¹⁰ Department of Medical Oncology, Institut Curie/Saint-Cloud, Saint-Cloud. Electronic address: https://twitter.com/EtienneB66.
¹¹ Drug Development Department (DITEP), Gustave Roussy, Villejuif; Paris Saclay University, Villejuif, France. Electronic address: https://twitter.com/CapuBaldini.
¹² Department of Medicine, The Royal Marsden NHS Foundation Trust, London, UK. Electronic address: https://twitter.com/nicolobattisti.
¹³ Department of Medical Oncology, Gustave Roussy, Villejuif, France. Electronic address: https://twitter.com/frelaut_m.
¹⁴ Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore. Electronic address: https://twitter.com/ravikanesvaran.
¹⁵ College of Medicine and Public Health, Flinders University, Adelaide; Department of Medical Oncology, Flinders Centre for Innovation in Cancer, Adelaide, Australia. Electronic address: https://twitter.com/AnnaMislang.
¹⁶ Department of Medical Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus.
¹⁷ Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury; UNSW School of Clinical Medicine, Rural Clinical Campus, Albury; John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Australia. Electronic address: https://twitter.com/drcbsteer.
¹⁸ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway. Electronic address: https://twitter.com/SRostoft.

Abstract

With the aging population, older adults constitute a growing proportion of the new cancer cases. Given the heterogeneous health status among older adults and their susceptibility to aging-related vulnerabilities, understanding their diversity and its implications becomes increasingly crucial for prognostication and guiding diagnostics, treatment decisions, and follow-up, as well as informing supportive care interventions. Geriatric assessment and management (GAM) refers to the comprehensive evaluation of an older individual's health status with subsequent management plans focusing on both oncologic and non-oncologic interventions. In 2019, the European Society for Medical Oncology (ESMO) and the International Society of Geriatric Oncology (SIOG) established the ESMO/SIOG Cancer in the Elderly Working Group. This position paper reflects the recommendations of the working group. Our paper summarizes the existing evidence with a focus on recent key trials and based on this, we propose several recommendations and future directions.

Keywords: cancer; geriatric assessment; management; older adults.

Publication types

Review

MeSH terms

Aged
Aged, 80 and over
Geriatric Assessment* / methods
Geriatrics / methods
Humans
Medical Oncology / methods
Medical Oncology / standards
Neoplasms* / therapy