Geriatric Assessment in Predicting Chemotherapy Toxicity and Vulnerabilities in Older Patients With Cancer

PRIMARY OBJECTIVES:

I. To identify areas of vulnerability in older adults with cancer through the use of a
geriatric assessment, and to identify the potential referrals to an interdisciplinary team
based on geriatric assessment results.

II. To determine whether the geriatric assessment driven interventions will lead to decrease
in grade 3-5 toxicity.

SECONDARY OBJECTIVES:

I. To determine whether the geriatric assessment driven interventions will lead to
improvement in the following outcomes: unplanned hospitalization, average length of stay
(ALOS), emergency visits, unplanned readmission rates, and advance directive completion.

II. To determine whether there is significantly better quality of life (QOL) and function in
the geriatric assessment intervention group compared to the standard of care group from start
of treatment to the follow-up timepoint.

III. To determine the feasibility of delivering geriatric assessment driven interventions in
a community setting using telemedicine.

OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients follow an intervention plan
created by the Nurse Practitioner (NP) using the results of the geriatric assessment. The NP
discusses the results of the assessment and treatment recommendations with the patient. They
also share the treatment plan, proposed referrals, and specific vulnerabilities with the
Primary Care Physician and community oncologist. Some patients complete the intervention plan
via Telehealth, which uses telecommunication technology to provide health services over a
distance. ARM II: Patients follow a standard of care treatment plan at the discretion of the
primary oncologist. Beginning 6 months from the start of chemotherapy, patients undergo the
geriatric assessment as in Arm I. Some patients complete the standard of care treatment plan
via Telehealth.

Inclusion Criteria:

- Diagnosis of a solid tumor malignancy (any stage)

- Scheduled to start a new chemotherapy regimen (any line, combination cytotoxic
chemotherapy with targeted agents are allowed)

- English, Spanish, and/or Chinese speaking

- Able to provide written informed consent

Exclusion Criteria:

- Not fluent in English, Spanish and/or Chinese