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A B S T R A C T S
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Disclosure of interest:
None declared
S10
ORGANIZATION MODELS OF THE CLINICAL ACTIVITY AT
THE GIOGER CENTERS
Lucia Fratino
Oncology Unit, Aviano (PN), Italy
Purpose:
The aim of the paper is to describe the organiza-
tion of the clinical activity of Geriatric Oncology in order to see
if an Italian model may exists and can be proposed elsewhere.
Methods:
An activity of Geriatric Oncology is carried out in
several Operative Units of Medical Oncology and Geriatrics of
GIOGer centers.Activityof GeriatricOncology is predominantly
carried out based in Divisions of Medical Oncology in General
Hospitals. The cooperation with Surgeons and Radiotherapist
in managing older cancer patients is generally described as
satisfactory. Patients are recruited in the Medical Oncology
Division by GP and Geriatricians. Where Geriatricians are
present there is a cooperation of Medical Oncologists with
Geriatricians, mainly with selected cases discussions, but
but periodically scheduled cases discussions are lacking.
With only one exceptions common clinics do not exist. The
Multidimensional Geriatric Evaluation (MGE) is performed
almost in all Departments, but not in all consecutive cases
At least four research project are founded by the Ministry of
Health and some other by Pharmaceuticals.
Conclusions:
It is necessary to define the interaction
modalities and procedures between the Geriatric Oncology
Unit and the structure dismissing the patient. Main aspects
defined by the GIOGer centers are: to establish efficient
communication paths; to define the relationships and
synergies among the professional figures involved in the
management of the patient (medical oncologist, MMG,
geriatrician, nurse); to establish preferential pathways for
admission and dismission (questo è inventato) from and to
the acute care ward and the community assistance network
for elderly patients undergoing therapy with chemotherapy
related toxicities. An Operative integrating protocol between
the territorial services and the National cancer institute will
allow the admission of oncological patients in the home care
assistance services and, for frail and more complex patients,
their admission in residenze sanitarie assistenziali.
Disclosure of interest:
None declared
S11
GENITOURINARY TUMORS IN THE ELDERLY PATIENTS
Lucia Fratino
Oncology Unit, Aviano (PN), Italy
Prostate cancer affects older men and is the most prevalent
cancer in men over 70 years. Management of the disease
in elderly men represents a major public health problem,
because many patients do not receive optimal therapy as the
result of treatment decisions made primarily on the basis of
chronological age alone. Several population-based studies
showed men aged 70–79 years had a significant fivefold
increased risk of not receiving curative treatment relative to
men aged 60–69 years. Older patients are also more likely to
present with very advanced disease and have a greater risk
of death resulting from prostate cancer, despite higher death
rates from competing causes. Docetaxel chemotherapy was
shown to improve overall survival (OS) and can be used safely
in selected elderly patients with castration resistant prostate
cancer (CRPC), although the optimal management of frail
patients remains to be established. In the post-docetaxel
setting, treatment options for both younger and older
patients with metastatic CRPC (mCRPC) include: cabazitaxel;
the androgen biosynthesis inhibitor abiraterone acetate
in combination with corticosteroids; and the
α
-emitter
radium-223 dichloride. Additionally, elderly patients are
generally more frail and have a higher risk of AEs. These
patients may be unable to tolerate or do not want to receive
cytotoxic chemotherapies.
Disclosure of interest:
None declared
S12
IS IMMUNITY COMPROMISED IN THE ELDERLY AND DOES
THIS IMPACT ON CANCER IMMUNOTHERAPY?
Tamas Fulop
Université de Sherbrooke, Medicine, Sherbrooke, QC, Canada
Aging is accompanied by many changes and one of the
most important affects the immune system. There are many
changes in all compartments of the immune system with
aging. The common actual view is that all these changes
are detrimental as they underline most of the age-related
diseases including cancers. Beside the immune system
alterations occurring with aging there exists also a low
grade inflammation originating from the life-long antigenic
challenges. The innate and the adaptive immune system
concomitantly or because of the inflammation become
dysfunctional. These changes may be either considered
detrimental or being adaptational due to a remodeling
induced by the immune history.There are numerous tentative
tomodulate the altered immune responsewith aging, however
there is no proof that it could be beneficial and no specific
pathways were targeted. The cancer immunotherapy is more
and more used even in elderly subjects and the common
belief is that the “immunosenescence” is compromising its
efficacy. We will discuss whether the age-related changes are
really impacting on the efficacy of the immunotherapy and
which could be the avenues to improve it in the elderly
Disclosure of interest:
None declared