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A B S T R A C T S
- Identify risk factors for chemotherapy toxicity in older
adults with cancer and manage treatment accordingly
A final round of the Delphi is being conducted to confirm
the consistency of these findings and the final list of geriatric
oncology competencies will be presented.
Conclusion:
Experts in both geriatric oncology and
oncology education agreed upon a set of geriatric oncology
competencies that are appropriate for oncology trainees.
These results will form the groundwork for the development
of a geriatric oncology curriculum for medical oncology
trainees and oncologists.
Disclosure of interest:
None declared
Keywords:
Competencies, Delphi consensus, education,
medical oncology
P140
GERIATRIC RESEARCH POLICY OF THE JAPAN CLINICAL
ONCOLOGY GROUP
T. Mizutani
1,
*, K. Nakamura
1
, A. Ogawa
2
, T. Hmaguchi
1
,
H. Fukuda
1
, F. Nagashima
3
1
National Cancer Center, Tokyo,
2
National Cancer Center Hospital
East, Chiba,
3
Kyorin University School of Medicine, Tokyo, Japan
Introduction:
The goal of the Japan Clinical Oncology
Group (JCOG) is to establish better standard treatments for
various cancer types and has thus conducted several pivotal
randomized controlled trials. Due to the rapidly increasing
ageing population in Japan, clinical research focused on
elderly cancer patients is urgently needed. We have therefore
organized the Geriatric Study Committee (GSC) in JCOG to
develop a geriatric research policy.
Objectives:
The missions of the GSC are as follows (1)
to define the subject selection policy of geriatric research
in JCOG trials; (2) to establish the standard endpoints and
methodological schemes for geriatric research and (3) to
determine the standard tools of geriatric assessment (GA).
Methods:
Therefore, the GCS have held quarterly meetings
since 2014 with members from each disease/modality-
oriented JCOG subgroup. The policy (in Japanese) developed
by the GCS has been extensively reviewed by Executive
Committee members of the JCOG and was activated in May
2016.
Results:
(1) We defined the subject selection policy of
geriatric research by treatment tolerance and chronological
age. We categorized elderly cancer patients into three
conceptual groups: ‘fit elderly cancer patients’ who can
undergo standard treatments as for younger patients; ‘frail
elderly patients’ for whom best supportive care or palliative
care is indicated and ‘vulnerable elderly patients’; those
between ‘fit elderly patients’ and ‘frail elderly patients’. Our
main target for geriatric research is the group of ‘vulnerable
elderly patients’.
(2) The endpoints of geriatric research should include some
GA components, such as physical and cognitive function, in
addition to survival data. From this viewpoint, ‘co-primary
endpoints’ or ‘composite endpoints’ incorporating GA into the
decision rule is often applicable. Furthermore, we classified
typical study designs for the elderly adopted in JCOG into (i) a
randomized controlled trial to establish standard treatments
specifically for elderly cancer patients, (ii) a single arm trial
to extrapolate the results of pivotal trials for the younger
population to elderly cancer patients and (iii) an observational
study for the broader population to explore predictive factors
for survival, functional impairment, or QOL decline.
(3) We determined recommended GA tools from the
viewpoint of simplicity and discriminative power. G8, a
geriatric screening tool, is to be used in all JCOG geriatric
research. Instrumental activities of daily living (IADL),
Charlson comorbidity index (CCI), MINI-COG and the social
situation are also strongly recommended. Other appropriate
tools can be applied depending on the purpose of each
disease/modality-oriented study.
Conclusion:
This JCOG Geriatric Research Policy identified
various issues, which commonly occur in geriatric research.
We expect that this policy would serve as a practical
framework in planning future geriatric research.
Disclosure of interest:
None declared
Keywords:
Geriatric research, policy
P141
COUPLES COPING WITH CANCER IN THE PLATINUM STAGE
OF LIFE: OLDEST-OLD AND THEIR SPOUSAL CAREGIVERS
G. Goldzweig
1
, E. Andritsch
2
, R. Pfeffer
3
, L. Baider
3
,
Y. Rottenberg
4,
*
1
School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College,
Tel-aviv, Israel,
2
Division of Clinical Oncology, The medical
University of Graz, Graz, Austria,
3
Assuta Medical Center, Oncology
Institute, Tel-aviv,
4
Hadassah - Hebrew University Medical Center,
Jerusalem, Israel
Introduction:
The share of the oldest-old (age 86 years old
and above) in the population is estimated to grow rapidly
in the next decades. Yet not much is known about this
population’s adaptation to cancer.
Objectives:
The objective of the current study is to describe
the psychological reaction of the oldest-old and their spousal
caregivers to cancer.
Methods:
Participants were 45 cancer patients, aged 86
years old or above and their spousal caregivers. Participants
completed standardized questionnaires for depression (5-
item GDS), distress (Distress Thermometer), hope (Snyder’s
Hope Scale) and social support (CPASS).
Results:
Patients reported extremely high levels of distress
and low levels of hope. Patients reported high levels of hope
in regard to feeling no pain and to dying without pain but
low levels of hope in regard to staying alive. Spouses reported
significantly lower levels of distress and higher levels of hope.
Patient distress measures were positively correlated with
caregiver levels of hope. There was a significant negative
correlation between caregiver levels of distress and social
support from friends.