Integration of geriatric assessment-guided care plan modifications and interventions into clinical paths of older adults with cancer (GORILLA): a feasibility approach.

内容摘要

A comprehensive geriatric assessment (CGA) followed by geriatric assessment-guided interventions was demonstrated to reduce treatment-related toxicities CTCAE III&#xb0;-V&#xb0; in older adults with cancer undergoing systemic cancer treatments, but implementation remains insufficient. Thus, we aimed to evaluate the feasibility of implementing CGA into routine care and multidisciplinary tumor boards (MDTs) in Germany within a bicentric feasibility trial (DRKS00035569; 19.12.2024). Patients&#x2009;&#x2265;&#x2009;65&#xa0;years with positive geriatric screening (G8&#x2009;<&#x2009;15 points) and all patients&#x2009;&#x2265;&#x2009;70&#xa0;years received CGA as part of their routine care. Results were presented during MDT discussions to derive treatment recommendations. After CGA, patients were asked for trial participation which included data analysis and a telephone follow-up after 3&#xa0;months. Clinicians participating in the MDT were asked about the added value of CGA presentation. Primary endpoint was the estimation of patient's willingness to participate with an accuracy of&#x2009;&#xb1;&#x2009;7.5% to inform design for a later (cost) effectiveness trial. 75 patients received CGA (62.5% females). Of those, 72 (96%) agreed to participate (95% confidence interval, [0.8875; 0.9917]). With an accuracy of estimating the willingness to participate of&#x2009;< |7.5%|, the primary endpoint was reached. The median age was 76.7&#xa0;years (range 69-92&#xa0;years). A member of the geriatric team attended 2/3 of MDT meetings. Clinicians rated the integration of CGA results predominantly as useful. Integration of CGA into routine care of older cancer patients is feasible but will likely require adequate geriatric staffing per center. A larger implementation study, evaluating efficacy and cost-effectiveness in the German healthcare system, is necessary.