Brain Cancer Survival Has Improved – But Not Much for Elderly

A new study from Helsinki University Hospital, University of Helsinki and the Finnish Cancer Registry shows that survival after glioblastoma has improved since the millennium. The improvement in survival was, however, modest in elderly patients, raising concerns whether current treatment strategies are optimal for this patient group.

“Glioblastoma is the most common brain , and one of the deadliest cancers known. Unfortunately, there is no cure for these rapidly progressing tumors.”

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Immunotherapy Outcomes May Be Better in Older Patients With Melanoma

Excerpt:

“Older patients with melanoma may respond better to anti-PD-1 immunotherapy treatment than their younger counterparts, according to a recent study published in Clinical Cancer Research, a journal from the American Association for Cancer Research.

“Researchers collected melanoma tissue samples from 538 patients from the United States, Australia and Germany. The samples were then divided into two categories: those belonging to people over the age of 62 and those belonging to people younger than 62. All of the patients were treated with the immunotherapy agent, Keytruda (pembrolizumab), which targets and blocks PD-1, making the immune system more likely to identify and attack cancer cells.”

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Many Elderly Lung Cancer Patients Receive No Treatment

Excerpt:

“Nearly two-thirds of older patients with stage III lung cancer do not receive any treatment, according to a new study.

“Although more than one-third of new lung cancers are diagnosed in patients age 75 years and older, elderly patients may not receive standard-of-care therapy for lung cancer—concurrent chemotherapy and radiation—due to their age, concerns about fragility, less willingness of patients to pursue aggressive therapy, or concerns over the usefulness of therapy for patients with competing risk factors.”

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Glioblastoma Clinical Trial Shows Combined Therapy Extends Life for Patients 65 and Older

Excerpt:

“Treating older patients who have malignant brain cancer with the chemotherapy drug temozolomide plus a short course of radiation therapy extends survival by two months compared to treating with radiation alone, show clinical trial results published in the New England Journal of Medicine.

“For 45% of the study participants, improved survival almost doubled — from 7 months to 13.5 months, says co-principal investigator Normand Laperriere, radiation oncologist at Princess Margaret Cancer Centre, University Health Network. This was linked to a molecular marker that indicated if a DNA repair mechanism against the drug was active. When the mechanism was ‘off,’ tumours responded better to treatment.”

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Older Lung Cancer Patients Experience Excellent Survival Following Surgery

Excerpt:

“Patients aged 65 years and older are living longer after lung cancer surgery, and with older people representing a rapidly growing proportion of patients diagnosed with lung cancer, this improved survival is especially significant, according to an article posted online today by The Annals of Thoracic Surgery.

“The American Cancer Society estimates that the median age at diagnosis for lung cancer is 70, supporting the premise that lung cancer is predominantly a disease of the elderly. Despite this, older patients with cancer are generally under-represented in clinical cancer trials, including those for lung cancer. This makes the study by Felix G. Fernandez, MD, from the Emory Clinic in Atlanta, and colleagues particularly important.”

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Older Breast Cancer Patients Defy Survival Models

“Older women with early-stage, invasive breast cancer had better survival rates than what was estimated by a popular online tool for predicting survival, according to researchers at the Duke Cancer Institute.

“The finding provides a stronger rationale for women over the age of 70 — even those who have additional minor health concerns — to undergo aggressive treatments such as chemotherapy to prevent their cancer from returning.

“ ‘When making decisions about whether or not to use potentially toxic preventive chemotherapy for breast cancer in older women, patients and doctors debate what they should do,’ said Gretchen Kimmick, M.D., M.S., an associate professor of medicine at Duke who is presenting the study findings at the San Antonio Breast Cancer Symposium. ‘This predictive model can help us show patients that they are going to survive long enough to see the benefit of treatment.’ “


High Use of Alternative Medicine in Senior Oncology Patients

“Alternative medicines are widely thought to be at least harmless and very often helpful for a wide range of discomforts and illnesses. However, although they’re marketed as ‘natural,’ they often contain active ingredients that can react chemically and biologically with other therapies. Researchers performed a comprehensive review of all of the medications taken by senior oncology patients and found that as 26 percent were using complementary or alternative medicines (CAM), in a report published August 12th, in the Journal of Geriatric Oncology.

“ ‘Currently, few oncologists are aware of the alternative medicines their patients take,’ said Ginah Nightingale, PharmD, an Assistant Professor in the Jefferson College of Pharmacy at Thomas Jefferson University. ‘Patients often fail to disclose the CAMs they take because they think they are safe, natural, nontoxic and not relevant to their cancer care, because they think their doctor will disapprove, or because the doctor doesn’t specifically ask.’ “


ASCO Calls for Cancer Trials to Include More Seniors

“In a position statement published online July 20 in the Journal of Clinical Oncology, the American Society of Clinical Oncology has called on the U.S. government and the cancer research community to broaden clinical trials to include older adults.

” ‘Older people living with cancer often have different experiences and outcomes in their treatment than younger cancer patients,’ Julie Vose, M.D., M.B.A., society president, said in a news release from the group. ‘As we age, for example, the risk of adverse reactions from treatment significantly increases. Older adults must be involved in clinical trials so we can learn the best way to treat older cancer patients, resulting in improved outcomes and manageable toxicity,’ she explained.

“More than 60 percent of cancers in the United States occur in people aged 65 and older, the statement authors say, noting the number of seniors will increase in coming years. However, there is a lack of evidence about cancer treatments for the elderly because too few are included in clinical trials, and clinical trials designed specifically for seniors are rare.”


Geriatric Patients with Cancer at Risk for Potentially Inappropriate Medication Use

“The prevalence of polypharmacy, excessive polypharmacy and potentially inappropriate medicine use was high among senior patients with cancers, according to results of a pharmacist-led comprehensive medication assessment.

“ ‘Older adults with cancer are particularly prone to medication errors attributed to medication changes, complex regimens and incomplete information handoff between providers,’ Ginah Nightingale, PharmD, BCOP, assistant professor in the department of pharmacy practice of the Jefferson School of Pharmacy at Thomas Jefferson University, and colleagues wrote. ‘Polypharmacy and potentially inappropriate medication use warrant substantial interest and concern on behalf of medical oncologists and oncology health providers because of the perils associated with their use in this vulnerable population.’ “