Use of Comprehensive Geriatric Assessment in Oncology Patients to Aid in Treatment Decisions and Predict Chemotherapy Toxicity – A Guide for Oncology Physician

ABSTRACT: Purpose: The purpose of this article is to review the utility of pre-treatment Comprehensive Geriatric Assessment (CGA) and its impact on decision making regarding standard therapy versus less intensive therapy for frail or poor functional status oncology patients, as well as prospective prediction of chemotherapy-related toxicities. A guide for Oncology Physician Assistants. Method: A Medline database search was conducted utilizing PubMed and Ovid interphases for clinical studies, review articles and journal publications. Search terms included geriatric assessment, medical oncology, chemotherapy, frailty, toxicity, and functional status. Thirty-seven pertinent articles were retrieved and serve as the basis for this clinical review. Results: While there has been much published on the use of Comprehensive Geriatric Assessment in oncology, there is a lack of evidence-based research to demonstrate the utility of this tool by practicing physician assistants in this specialty. Conclusion: Frail and/or older patients present a considerable clinical challenge in Oncology practice and are at significant risk of treatment-related toxicities as a consequence of physiologic changes. Comprehensive Geriatric Assessment establishes evidence-based strategies to better assess the functional status of older oncology patients and provides estimates for chemotherapy-related toxicities in this vulnerable group. Further research is needed to provide Oncology PAs with the tools needed for CGA evaluation and implementation into practice