Elderly CAncer Patient

Condition(s) studied

Investigational drug(s) / intervention(s)

Extensive GA: GA includes an evaluation of nine domains according to international recommendations : * functional status (six-item Activities of Daily Living (ADL) score, Instrumental Activities of Daily Living (IADL)) * mobility (timed get-up-and-go test, one-leg standing balance test, history of fall) * nutritional status (French National Authority of Health guidelines, weight loss body mass index (BMI), Mini Nutritional Assessment, albumin ) * cognitive status (Mini-Mental State Examination (MMSE), history of dementia, confusion) * mood (Mini-Geriatric Depression Scale (Mini-GDS), symptoms of anxiety, depression (DSM V)) * comorbidities (CIRS G) * polypharmacy (number of medications) * social environment (primary caregiver, support at home, friends , family, living alone) * urinary and/or fecal incontinence

Study summary

The management of older patients with cancer has become a major public health concern in Western countries because of the aging of the population and steady increase in cancer incidence with advancing age. Cancer treatment of aged patients is complex due to comorbidities, polypharmacy and functional status. The heterogeneity of the older population in terms of comorbidities and functional status may explain the difficulty in establishing management recommendations.

Study hypothesis is that a geriatric consultation using Geriatric Assessment (GA) can evaluate patient's resource and strengths, in order to help oncologist to define the most effective treatment. The GA developed by geriatricians and recommended by the International Society of Geriatric Oncology (SIOG), is a multidimensional assessment of general health status; comorbidities; functional status; nutritional, cognitive, psychological, and social parameters; and medications. The GA uses validated geriatric scales to produce an inventory of problems, which can then serve to develop an individualized geriatric intervention plan; it may be an important step in selecting elderly patients for cancer screening and treatment.

The objectives are:

* To assess the role of GA for decision making process for older patients with cancer
* To identify geriatric and oncologic factors associated with overall survival, treatment feasibility, toxicities, morbidities
* To develop and/or validate screening tests for frailty in geriatric oncology
* To develop and validate frailty classifications

Method: The ELCAPA (ELderly CAncer PAtient) survey is a French multicentric prospective study that includes all patients age 70 years or older who has a diagnosis of solid cancer or hematologic malignancies in French hospitals

Eligibility

Primary outcome measure(s)

• Difference between initial oncologist treatment proposal and final treatment selected after geriatric assessment — through multidisciplinary meeting decision, an average of 2 weeks after GA (+/-1 week).

Trial sites (1)

More Assistance Publique - Hôpitaux de Paris trials in France

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