Article
Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update
Journal of Clinical Oncology
(2023)
Abstract
PURPOSE
To update the ASCO guideline (2018) on the practical assessment and management of age-associated vulnerabilities in older patients undergoing systemic cancer therapy.
METHODS
An Expert Panel conducted a systematic review to identify relevant randomized clinical trials (RCTs), systematic reviews, and meta-analyses from January 2016 to December 2022.
RESULTS
A total of 26 publications met eligibility criteria and form the evidentiary basis for the update.
RECOMMENDATIONS
The Expert Panel reiterates its overarching recommendation from the prior guideline that geriatric assessment (GA), including all essential domains, should be used to identify vulnerabilities or impairments that are not routinely captured in oncology assessments for all patients over 65 years old with cancer. Based on recently published RCTs demonstrating significantly improved clinical outcomes, all older adults with cancer (65+ years old) receiving systemic therapy with GA-identified deficits should have GA-guided management (GAM) included in their care plan. GAM includes using GA findings to inform cancer treatment decision-making as well as to address impairments through appropriate interventions, counseling, and/or referrals. A GA should include high priority aging-related domains known to be associated with outcomes in older adults with cancer: physical and cognitive function, emotional health, comorbid conditions, polypharmacy, nutrition, and social support. Clinical adaptation of the GA based on patient population, resources, and time is appropriate.
Keywords
- geriatric assessment,
- older adults,
- cancer,
- chemotherapy,
- guideline,
- treatment
Disciplines
Publication Date
Summer July 17, 2023
DOI
DOI: 10.1200/JCO.23.00933
Citation Information
William Dale, Heidi Klepin, Grant Williams, Shabbir Alibhai, et al.. "Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update" Journal of Clinical Oncology Vol. online (2023) p. 1 - 20 ISSN: 1527-7755 Available at: http://works.bepress.com/tracy-ruegg/6/