Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

The effect of comprehensive geriatric assessment on care received, treatment completion, and outcomes for older adults receiving systemic anti-cancer treatment: A systematic review (#450)

Domenica Disalvo 1 , Erin Moth 2 3 4 , Wee-Kheng Soo 5 6 7 , Maja V Garcia 1 , Prunella Blinman 2 8 , Christopher Steer 9 10 , Ingrid Amgarth-Duff 1 , Jack Power 1 , Jane Phillips 11 , Meera Agar 1
  1. IMPACCT – Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Ultimo, NSW, Australia
  2. Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  3. Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
  4. Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia
  5. Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
  6. Cancer Services, Eastern Health, Melbourne, Victoria, Australia
  7. Department of Aged Medicine, Eastern Health, Melbourne, Victoria, Australia
  8. Concord Repatriation General Hospital, Sydney, New South Wales, Australia
  9. School of Clinical Medicine, University of New South Wales, Rural Clinical Campus, Albury, NSW, Australia
  10. Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
  11. School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia

Introduction: This systematic review aims to summarise the available literature on the effect of geriatric assessment (multidimensional health assessment across medical, social, and functional domains; “GA”) or comprehensive geriatric assessment (geriatric assessment with intervention or management recommendations; “CGA”) compared to usual care for older adults with cancer on care received, treatment completion, adverse treatment effects, survival and health-related quality of life.

Materials and Methods: A systematic search of MEDLINE, EMBASE, CINAHL, and PubMed was conducted to identify randomised controlled trials or prospective cohort comparison studies on the effect of GA/CGA on care received, treatment, as well as cancer- and geriatric-domain outcomes for older adults with cancer.

Results: Ten studies were included, seven randomised controlled trials (RCTs), two phase II randomised pilot studies, and one prospective cohort comparison study. All studies included older adults receiving systemic anticancer therapy, mostly chemotherapy, for mixed cancer types (eight studies), colorectal cancer (one study), and non-small cell lung cancer (one study). Integrating GA/CGA into oncological care increased treatment completion (three of nine studies), reduced grade 3+ chemotherapy toxicity (two of five studies), and improved quality of life scores (four of five studies). No studies found significant differences in survival between GA/CGA and usual care. GA/CGA incorporated into care decisions prompted less intensive treatment approaches and greater use of non-oncological interventions, including supportive care strategies.

Discussion: GA/CGA integrated into the care of an older adult with cancer has the potential to optimise care decisions, which may lead to reduced treatment toxicity, increased treatment completion, and improved health-related quality of life.