A5033121973- Frailty in Older Adults
- Cancer survivorship and care
- Health Systems, Economic Evaluations, Quality of Life
- Nutrition and Health in Aging
- Palliative Care and End-of-Life Issues
- Pharmaceutical Practices and Patient Outcomes
- Inflammatory Biomarkers in Disease Prognosis
- Medication Adherence and Compliance
- Cancer-related cognitive impairment studies
- Cancer Treatment and Pharmacology
- Economic and Financial Impacts of Cancer
- Occupational and environmental lung diseases
- Glioma Diagnosis and Treatment
- Colorectal Cancer Treatments and Studies
- Family Support in Illness
- Liver Disease and Transplantation
- Hepatocellular Carcinoma Treatment and Prognosis
- Multiple and Secondary Primary Cancers
- Inflammasome and immune disorders
- Patient-Provider Communication in Healthcare
- Cardiac, Anesthesia and Surgical Outcomes
- Gastric Cancer Management and Outcomes
- Chronic Disease Management Strategies
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Intensive Care Unit Cognitive Disorders
University of Rochester
2019-2025
University of Rochester Medical Center
2015-2025
<h3>Importance</h3> Financial toxicity (FT), unintended and unanticipated financial burden experienced by cancer patients undergoing care, is associated with negative consequences increased risk of mortality. Older (≥70 years) are at for FT, yet data limited on FT whether oncologists discuss their patients. <h3>Objective</h3> To examine the prevalence in older adults advanced cancer, its association health-related quality life (HRQoL), cost conversations between <h3>Design, Setting,...
12009 Background: GA evaluates aging-related domains (e.g., function) known to be associated with cancer treatment toxicity. In this CRCT, we evaluated if providing a summary management recommendations oncologists can reduce toxicity in older patients (pts) advanced receiving chemotherapy and/or other agents high reported prevalence of grade 3-5 Methods: Pts aged > 70 incurable solid tumors or lymphoma and 1 impaired domain starting new regimen were enrolled. Community oncology practices...
Abstract Purpose Polypharmacy is prevalent in older adults starting cancer treatment and associated with potentially inappropriate medications (PIM), potential drug-drug interactions (DDI), drug-cancer (DCI). For a large cohort of vulnerable advanced treatment, we describe patterns prescription nonprescription medication usage, the prevalence PIM, prevalence, severity, type DDI/DCI. Methods This secondary analysis used baseline data from randomized study enrolling patients aged ≥70 years new...
Abstract Background Polypharmacy is common in older adults who are starting cancer treatment and associated with an increased risk of potentially inappropriate medications (PIMs) potential drug‐drug interactions (PDIs). The authors evaluated the association medication measures adverse outcomes advanced were receiving systemic therapy. Methods This secondary analysis from GAP 70+ Trial (ClinicalTrials.gov identifier NCT02054741; principal investigator, Supriya G. Mohile) enrolled patients...
PurposeTo evaluate and compare outcome of stereotactic body radiation therapy (SBRT), yttrium-90 radioembolization, radiofrequency ablation (RFA), or transarterial chemoembolization (TACE) as bridge to liver transplant (LT) in patients with hepatocellular carcinoma.Methods materialsWe retrospectively reviewed treated at our institution SBRT, TACE, RFA, LT between 2006 2013. We analyzed radiologic pathologic response rate failure after therapy. Toxicities were reported using Common...
Abstract Background Ensuring older patients with advanced cancer and their oncologists have similar beliefs about curability is important. We investigated discordance in patient-oncologist caregiver-oncologist dyads. Materials Methods used baseline data from a cluster randomized trial assessing whether geriatric assessment improves communication quality of life caregivers. Patients were aged ≥70 years incurable community oncology practices. Patients, caregivers, asked: “What do you believe...
Little is known about the effects of chemotherapeutic drugs on DNA methylation status leukocytes, which may be predictive treatment benefits and toxicities. Based a prospective national study, we characterize changes in leukocyte methylome from pre- to post-chemotherapy (approximately 4 months apart) 93 patients treated for early stage breast cancer 48 matched non-cancer controls. We further examined significant with perceived cognitive impairment, clinically problem related chemotherapy....
Providing a geriatric assessment (GA) summary with management recommendations to oncologists reduces clinician-rated toxicity in older patients advanced cancer receiving treatment. This secondary analysis of national cluster randomized clinical trial (ClinicalTrials.gov identifier: NCT02054741) aims assess the effects GA intervention on symptomatic measured by Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE).
Importance Older adults with advanced cancer are less likely to tolerate treatment cytotoxic chemotherapy compared younger patients due their aging-related conditions. Hence, oncologists sometimes opt employ primary modifications (deviation from standard of care) during the first cycle chemotherapy. Objective To examine association between modification and tolerability in older who were starting new palliative regimens. Design, Setting, Participants This cohort study was a secondary analysis...
Older adults with advanced cancer frequently experience declines in physical performance and daily functioning during systemic therapy, higher patient‐reported symptomatic toxicities correlating new impairments performance. Although clinician‐rated do not predict performance, are associated increased risk of functional decline, suggesting that integrating both types assessments could guide interventions to address these declines.
Background: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults with cancer, but their associations physical function not often studied. This study examined the of polypharmacy PIMs determined optimal cutoff value for number most strongly associated functional impairment. Methods: cross-sectional analysis used baseline data from a randomized enrolling patients aged ≥70 years advanced cancer starting new systemic treatment. We categorized PIM using 2015...
Cancer-related cognitive decline (CRCD) is an important clinical problem, but limited research exists on assessment of function in patients with lymphoma.The overall objective this nationwide, prospective, observational study conducted the National Cancer Institute Community Clinical Oncology Research Program (NCORP) was to assess changes memory, attention, and executive lymphoma from pre- (A1) postchemotherapy (A2) 6 months (A3). Individuals without cancer served as noncancer controls,...
Frailty is associated with an increased risk of chemotherapy toxicity. Cellular markers inflammation can help identify patients frailty characteristics. However, the role cellular in identifying at developing chemotherapy-induced and their clinical utility are not fully understood.This study was a secondary analysis large nationwide cohort women stage I-IIIC breast cancer (n = 581, mean age 53.4; range 22-81). Measures were completed pre-chemotherapy (T1), post-chemotherapy (T2), 6 months...
Importance Older adults with advanced cancer who have high pretreatment symptom severity often experience adverse events during treatments. Unsupervised machine learning may help stratify patients into different risk groups. Objective To evaluate whether clusters identified from baseline patient-reported were associated outcomes. Design, Setting, and Participants This secondary analysis of the Geriatric Assessment Intervention for Reducing Toxicity in Patients With Advanced Cancer (GAP70+)...
More older adults die from lung cancer worldwide than breast, prostate, and colorectal cancers combined. Current treatments may prolong life, but can also cause considerable treatment-related toxicity.This study is a secondary analysis of cluster-randomized clinical trial which evaluated whether providing geriatric assessment (GA) summary GA-guided management recommendations improve grade 3-5 toxicity among with advanced cancer.We analyzed participants aged ≥70 years(y) stage III & IV...
Older patients with advanced cancer often have comorbidities that can worsen their and treatment outcomes. We assessed how a geriatric assessment (GA)-guided intervention guide conversations about among patients, oncologists, caregivers.
A geriatric assessment (GA) intervention improves communication about aging-related concerns, but its effect on in patients with various levels of frailty is unknown.