Integrating geriatric oncology into clinical pathways and guidelines

Cancer is a disease of the elderly, and more research is needed to improve geriatric oncology care. The complexity of older cancer patients requires clinicians to consider a declining organs’ function and competing comorbidities to balance pros and cons of every treatment choice within the context of estimated life expectancy. A comprehensive geriatric assessment (CGA) is helpful and mandatory to establish an appropriate care plan as research demonstrated it can detect issues that would remain otherwise neglected and improve the care of older cancer patients. Predictive tools for chemotherapy toxicity may also help complete the assessment for patients eligible for anticancer therapy. Nevertheless, CGA may be timeconsuming, and several screening tools have been developed and validated to identify potential candidates for a full assessment. Due to the underrepresentation of older patients in clinical trials and the shortage of studies specifically addressing this population, a solid evidence base for the management of cancer in this setting is currently lacking. However, less robust levels of evidence may be used to inform treatment decisions. Therefore, the guidelines available can provide clinicians with the tools to pilot the care of older adults with cancer, yet more specific research in the field is awaited.