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Arti Hurria - One of the best experts on this subject based on the ideXlab platform.

  • Geriatric Assessment and Tools for Predicting Treatment Toxicity in Older Adults With Cancer.
    Cancer journal (Sudbury Mass.), 2017
    Co-Authors: Enrique Soto-perez-de-celis, Arti Hurria
    Abstract:

    Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used Assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The Geriatric Assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function. Among older patients with cancer, Geriatric Assessment has been shown to identify patients at risk of poorer overall survival, and Geriatric Assessment-based tools are significantly more effective in predicting chemotherapy toxicity than other currently utilized measures. In this review, we summarize the components of the Geriatric Assessment and provide information about existing tools used to predict treatment toxicity in older patients with cancer.

  • implementing a Geriatric Assessment in cooperative group clinical cancer trials calgb 360401
    Journal of Clinical Oncology, 2011
    Co-Authors: Arti Hurria, Hyman B. Muss, Alice B. Kornblith, Constance Cirrincione, William T Barry, Andrew S Artz, Linda Schmieder, Rafat Ansari, William P Tew, Douglas Weckstein
    Abstract:

    Purpose Factors captured in a Geriatric Assessment can predict morbidity and mortality in older adults, but are not routinely measured in cancer clinical trials. This study evaluated the implementation of a Geriatric Assessment tool in the cooperative group setting. Patients and Methods Patients age ≥ 65 with cancer, who enrolled on cooperative group cancer trials, were eligible to enroll on Cancer and Leukemia Group B (CALGB) 360401. They completed a Geriatric Assessment tool before initiation of protocol therapy, consisting of valid and reliable Geriatric Assessment measures which are primarily self-administered and require minimal resources and time by healthcare providers. The Assessment measures functional status, comorbidity, cognitive function, psychological state, social support, and nutritional status. The protocol specified criteria for incorporation of the tool in future cooperative group trials was based on the time to completion and percent of patients who could complete their portion without...

  • Geriatric Assessment in oncology practice
    Journal of the American Geriatrics Society, 2009
    Co-Authors: Arti Hurria
    Abstract:

    There is no standard tool for assessing the "functional age" of an older adult with cancer, although it is widely recognized that chronological age does not capture the heterogeneous physiological and functional status of older adults. Integrating a "Geriatric Assessment" into oncology research and clinical practice would help fill this void. Geriatric Assessment covers factors that predict morbidity and mortality in older adults, including functional status, comorbidity, cognition, psychological state, nutritional status, and social support. This Assessment provides a broader overall understanding of individual characteristics that affect life expectancy. In addition, this Assessment identifies areas of vulnerability in older adults for which further evaluation or intervention is indicated. This article will address the utility of a Geriatric Assessment in oncology practice, review data that attest to the benefits of the Assessment, and issue a call for further research into how this Assessment can be integrated into oncology care. Doing so will help develop targeted interventions and optimize cancer outcomes in this rapidly growing population.

  • Comprehensive Geriatric Assessment for Older Patients With Cancer
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2007
    Co-Authors: Martine Extermann, Arti Hurria
    Abstract:

    Purpose During the last decade, oncologists and Geriatricians have begun to work together to integrate the principles of Geriatrics into oncology care. The increasing use of a comprehensive Geriatric Assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a Geriatric Assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Acc...

  • Geriatric Assessment for oncologists: rationale and future directions.
    Critical reviews in oncology hematology, 2006
    Co-Authors: Arti Hurria, Mark S. Lachs, Harvery J. Cohen, Hyman B. Muss, Alice B. Kornblith
    Abstract:

    Sixty percent of all cancer occurrences and seventy percent of cancer mortalities occur in people over the age of 65. As the population ages, there is an emerging need to develop a means for oncologists to characterize the "functional age" of older patients with cancer in order to tailor treatment decisions and stratify outcomes based on factors other than chronological age and to develop interventions to optimize cancer treatment. In this paper, we discuss the formulation of a Geriatric Assessment for older patients with cancer. The measures included in this Assessment were chosen based on their validity, reliability, brevity, adaptability for self-administration, and ability to prognosticate risk for morbidity or mortality in an older patient. The proposed Geriatric Assessment covers the essential domains of Assessment predictive of survival in the Geriatric population, is primarily self-administered, and limited personnel time is required. Our eventual goal is to determine if this Geriatric Assessment measure can identify factors independent of age that predict cancer treatment morbidity and mortality and result in rationale interventions to optimize oncologic care.

Richard A Larson - One of the best experts on this subject based on the ideXlab platform.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14-2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07-2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13-2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54-4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric Assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of Geriatric Assessment prior to allogeneic transplantation may aid appropriate selection of older adults.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients.
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P

Lori S Muffly - One of the best experts on this subject based on the ideXlab platform.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14-2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07-2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13-2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54-4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric Assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of Geriatric Assessment prior to allogeneic transplantation may aid appropriate selection of older adults.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients.
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P

Hyman B. Muss - One of the best experts on this subject based on the ideXlab platform.

  • ASCO 2020: The Geriatric Assessment Comes of Age.
    The oncologist, 2020
    Co-Authors: Enrique Soto-perez-de-celis, Matti Aapro, Hyman B. Muss
    Abstract:

    This commentary provides an overview of four randomized clinical trials on the use of Geriatric Assessment to guide decisions and interventions for cancer care. These studies show the effect of Geriatric interventions on oncological outcomes, including toxicity, quality of life, and survival.

  • Geriatric Assessment in surgical oncology a systematic review
    Journal of Surgical Research, 2015
    Co-Authors: Hyman B. Muss, Megan A Feng, Daniel T Mcmillan, Karen Crowell, Matthew E Nielsen, Angela M Smith
    Abstract:

    Background The comprehensive Geriatric Assessment (CGA) has developed as an important prognostic tool to risk stratify older adults and has recently been applied to the surgical field. In this systematic review, we examined the utility of CGA components as predictors of adverse outcomes among Geriatric patients undergoing major oncologic surgery.

  • implementing a Geriatric Assessment in cooperative group clinical cancer trials calgb 360401
    Journal of Clinical Oncology, 2011
    Co-Authors: Arti Hurria, Hyman B. Muss, Alice B. Kornblith, Constance Cirrincione, William T Barry, Andrew S Artz, Linda Schmieder, Rafat Ansari, William P Tew, Douglas Weckstein
    Abstract:

    Purpose Factors captured in a Geriatric Assessment can predict morbidity and mortality in older adults, but are not routinely measured in cancer clinical trials. This study evaluated the implementation of a Geriatric Assessment tool in the cooperative group setting. Patients and Methods Patients age ≥ 65 with cancer, who enrolled on cooperative group cancer trials, were eligible to enroll on Cancer and Leukemia Group B (CALGB) 360401. They completed a Geriatric Assessment tool before initiation of protocol therapy, consisting of valid and reliable Geriatric Assessment measures which are primarily self-administered and require minimal resources and time by healthcare providers. The Assessment measures functional status, comorbidity, cognitive function, psychological state, social support, and nutritional status. The protocol specified criteria for incorporation of the tool in future cooperative group trials was based on the time to completion and percent of patients who could complete their portion without...

  • Geriatric Assessment for oncologists: rationale and future directions.
    Critical reviews in oncology hematology, 2006
    Co-Authors: Arti Hurria, Mark S. Lachs, Harvery J. Cohen, Hyman B. Muss, Alice B. Kornblith
    Abstract:

    Sixty percent of all cancer occurrences and seventy percent of cancer mortalities occur in people over the age of 65. As the population ages, there is an emerging need to develop a means for oncologists to characterize the "functional age" of older patients with cancer in order to tailor treatment decisions and stratify outcomes based on factors other than chronological age and to develop interventions to optimize cancer treatment. In this paper, we discuss the formulation of a Geriatric Assessment for older patients with cancer. The measures included in this Assessment were chosen based on their validity, reliability, brevity, adaptability for self-administration, and ability to prognosticate risk for morbidity or mortality in an older patient. The proposed Geriatric Assessment covers the essential domains of Assessment predictive of survival in the Geriatric population, is primarily self-administered, and limited personnel time is required. Our eventual goal is to determine if this Geriatric Assessment measure can identify factors independent of age that predict cancer treatment morbidity and mortality and result in rationale interventions to optimize oncologic care.

  • developing a cancer specific Geriatric Assessment a feasibility study
    Cancer, 2005
    Co-Authors: Arti Hurria, Harvey J. Cohen, Hyman B. Muss, Supriya Gupta, Marjorie G Zauderer, Enid L Zuckerman, Miriam B Rodin, Katherine S Panageas, Jimmie C Holland, Leonard Saltz
    Abstract:

    Background As the U.S. population ages, there is an emerging need to characterize the "functional age" of older patients with cancer to tailor treatment decisions and stratify outcomes based on factors other than chronologic age. The goals of the current study were to develop a brief, but comprehensive, primarily self-administered cancer-specific Geriatric Assessment measure and to determine its feasibility as measured by 1) the percentage of patients able to complete the measure on their own, 2) the length of time to complete, and 3) patient satisfaction with the measure. Methods The Geriatric and oncology literature was reviewed to choose validated measures of Geriatric Assessment across the following domains: functional status, comorbidity, cognition, psychological status, social functioning and support, and nutritional status. Criteria applied to Geriatric Assessment measurements included reliability, validity, brevity, and ability to self-administer. The measure was administered to patients with breast carcinoma, lung carcinoma, colorectal carcinoma, or lymphoma who were fluent in English and receiving chemotherapy at Memorial Sloan-Kettering Cancer Center (New York, NY) or the University of Chicago (Chicago, IL). Results The instrument was completed by 43 patients (mean age, 74 yrs; range, 65-87 yrs). The majority had AJCC Stage IV disease (68%). The mean time to completion of the Assessment was 27 minutes (range, 8-45 mins). Most patients were able to complete the self-administered portion of the Assessment without assistance (78%) and were satisfied with the questionnaire length (90%). There was no association noted between age (P = 0.56) or educational level (P = 0.99) and the ability to complete the Assessment without assistance. Conclusions In this cohort, this brief but comprehensive Geriatric Assessment could be completed by the majority of patients without assistance. Prospective trials of its generalizability, reliability, and validity are justified.

Quynh Chu - One of the best experts on this subject based on the ideXlab platform.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14-2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07-2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13-2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54-4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric Assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of Geriatric Assessment prior to allogeneic transplantation may aid appropriate selection of older adults.

  • Geriatric Assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients.
    Haematologica, 2014
    Co-Authors: Lori S Muffly, Masha Kocherginsky, Wendy Stock, Quynh Chu, Michael R Bishop, Lucy A Godley, Justin Kline, Hongtao Liu, Olatoyosi Odenike, Richard A Larson
    Abstract:

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of Geriatric Assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric Assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed Geriatric Assessment and underwent transplant. Median age was 58 years (range 50-73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59-3.56; P