This special supplement to Oncology News International presents 17 reports fromthe first annual Geriatric Oncology Consortium (GOC) multidisciplinary conference,‘‘Advancing Cancer Care in the Elderly.’’ Reports focus on issues in geriatric oncology,in particular team-based patient assessment and care delivery,adherence to medication, accrual to clinical trials, appropriate dosingthrough supportive therapy, radiation therapy, cognition problems, pain management,reassessment of outcomes, and caregiving issues.
BOCA RATON, Florida-Cancer treatment "success" in the veryelderly may depend not as much onimproving survival or achieving responseas on stabilizing disease or delayingprogression while minimizingtoxicity, according to Alan J. Koletsky,MD.Clinical trials traditionally focus onend points such as response rate, mediansurvival, or overall survival. Butfor older people with a life expectancyof less than 10 years, these outcomesmay not be relevant, said Dr. Koletsky,an oncologist with the Center for Hematology-Oncology, in Boca Raton,Florida.Relevant Outcomes"If you offered a patient the choiceof having stable disease for a period ofat least 6 months with a reasonablygood quality of life or a short-livedresponse achieved without insignificanttoxicity, he or she might preferthe former, which in a traditional phaseII study might not be considered aresponse," Dr. Koletsky said.Notably, a number of clinical developmentefforts have aimed at enhancingdrug tolerance without sacrificingthe efficacy of therapy:Enhancing Drug Tolerance,Preserving Efficacy
A majority of partial responders(78%) had symptom improvement, asdid more than half of patients withstable disease. Progression-free survivaltime was 4.2 months in patientswho had improvement in disease-relatedsymptoms, vs 2.0 months forthose who did not."This is an example of taking agroup of patients who would normallyhave a poor quality of life, and affordingthem the possibility of stabledisease and a reasonably good qualityof life," Dr. Koletsky said.