🇬🇧 Geriatric oncology: Moving the needle towards an evidence-based precision approach for older adults with cancer

Abstract

Cancer is a disease of ageing. Therefore, the management of older adults is a crucial part of the routine practice for the cancer workforce. Nonetheless, several gaps of knowledge exist in geriatric oncology, along with a significant variation in the management of cancer and its outcomes within and between countries. On the other hand, older adults with cancer are heterogeneous, and their management may be particularly complex. Therefore, geriatric assessments are crucial to inform a personalised and holistic treatment approach in a multi-disciplinary setting. Geriatric screening tools may assist with the selection of older patients requiring an oncogeriatric approach. An integrated oncogeriatric approach is a standard of care supported by international consensus in view of the significant benefits associated with this model of care. These involve a better estimation of prognosis, the prediction of complications and physical decline on cancer treatments, the identification of problems not found by routine baseline assessments or new problems during follow-up care, the reduction in the rates of severe toxicities and unplanned hospitalisations and the improvement of quality of life on systemic anticancer therapy.

The implementation of optimal clinical care models, fostering education in geriatric oncology, conducting research on the interface between cancer and ageing and collaborations with several stakeholders are instrumental to the advancement of the care of older adults with cancer at global level. Precision
oncology for this population should take into account not only markers of tumour biology, but also geriatric assessments in the context of what matters to patients.