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Adult Solid NeoplasmNCT02054741

Geriatric Assessment Intervention for Reducing Toxicity in Older Patients With Advanced Cancer

A study testing Comprehensive Geriatric Assessment, Quality-of-Life Assessment and Survey Administration in people with Adult Solid Neoplasm and Toxicity, run by Supriya Mohile at 23 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This cluster randomized clinical trial compares a geriatric assessment intervention with usual care for reducing cancer treatment toxicity in older patients with cancer that has spread to other places in the body. Read more about this study

Who is it for?
Ages 70 years and older
Conditions the study is for
Adult Solid Neoplasm, Toxicity, Lymphoma
What is being tested?
Comprehensive Geriatric Assessment, Quality-of-Life Assessment and Survey Administration
Could I receive a placebo?
No, everyone receives an active treatment
How many people
733 participants
Where
23 sitesUnited States
Study dates
29 Jul 2014to 31 Oct 2021
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 70 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Oncology physicians must work at a National Cancer Institute (NCI) Community Oncology Research Program (NCORP) practice site with no plans to leave that NCORP practice site or retire at the time of enrollment into the study
  • Diagnosis of an advanced solid tumor malignancy (advanced cancer) or lymphoma; in most situations, this would be a stage IV cancer; patients with a diagnosis of stage III cancer or lymphoma are eligible if cure is not possible or anticipated; clinical staging without pathological confirmation of advanced disease is allowed
  • Plan to start a new cancer treatment regimen within 4 weeks from time of baseline registration; the treatment regimen is up to the discretion of the treating oncology physician; the regimen must include a chemotherapy drug or other agents that have similar prevalence of toxicity; patients who will receive monoclonal antibody therapy or other cancer therapies (e.g., tyrosine kinase inhibitors) are eligible if other agents present a prevalence of toxicity similar to chemotherapy; patients who are receiving approved cancer treatment in combination with radiation are eligible; a patient may also be enrolled on a treatment trial and participate in this study, if all other inclusion and exclusion criteria are met. *Chemotherapy is defined as cytotoxic drugs; in addition, agents (e.g., monoclonal antibodies and targeted agents) that have a prevalence of grade 3-5 toxicity in older patients similar to chemotherapy (>50%) will be allowed.
  • Plan to be on chemotherapy or other allowable treatment for at least 3 months (minimum 70 days) and be willing to come in for study visits
  • Have at least one geriatric assessment domain meet the cut-off score for impairment other than polypharmacy
  • Able to provide informed consent, or if the oncology physician determines the patient to not have decision-making capacity, a patient-designated health care proxy (or authorized representative per institutional policies) must sign consent by the baseline visit. If the participant is found to be impaired on the Blessed-Orientation Memory Concentration Test (BOMC) during screening; they must have a health care proxy or authorized representative to be eligible to enroll.
  • Participant has adequate understanding of the English language

Who cannot join

  • Have surgery planned within 3 months of consent; patients who have previously received surgery are eligible
  • Presence of symptomatic brain metastases at time of study consent process. Patients with a history of treated brain metastases are eligible if they are not symptomatic at the time of study enrollment.

Trial locations and contacts

23 sites in 1 country.

23 sites in 1 country

United States23 sites
  • University of Chicago

    Chicago, Illinois, 60637

  • Columbus NCORP

    Columbus, Ohio, 43215

  • Geisinger Cancer Institute NCORP

    Danville, Pennsylvania, 17822

  • Dayton NCORP

    Dayton, Ohio, 45420

  • Heartland NCORP

    Decatur, Illinois, 62526

  • City of Hope

    Duarte, California, 91010

  • Cancer Research Consortium of West Michigan

    Grand Rapids, Michigan, 49503

  • NCORP of the Carolinas

    Greenville, South Carolina, 29615

  • Hawaii MU-NCORP

    Honolulu, Hawaii, 96813

  • Kansas City NCORP

    Kansas City, Missouri, 64131

  • North Shore LIJ Health System NCORP

    Lake Success, New York, 11042

  • Nevada NCORP

    Las Vegas, Nevada, 89106

  • Wisconsin NCORP

    Marshfield, Wisconsin, 54449

  • Aurora NCORP

    Milwaukee, Wisconsin, 53226

  • Metro Minnesota NCORP

    Minneapolis, Minnesota, 55426

  • Gulf South MU-NCORP

    New Orleans, Louisiana, 70112

  • Delaware/Christiana Care NCORP

    Newark, Delaware, 19713

  • Pacific Cancer Research Consortium Ncorp

    Portland, Oregon, 97213

  • Kansas City NCORP

    Prairie Village, Kansas, 66208

  • University of Rochester

    Rochester, New York, 14642

  • Northwest NCORP

    Tacoma, Washington, 98405-0986

  • Wichita NCORP

    Wichita, Kansas, 67214

  • Southeast Clinical Oncology Research Program

    Winston-Salem, North Carolina, 27104

Other trials in United States

About this study

Official title: A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer: Reducing Toxicity in Older Adults

This cluster randomized clinical trial compares a geriatric assessment intervention with usual care for reducing cancer treatment toxicity in older patients with cancer that has spread to other places in the body. A geriatric assessment may identify risk factors for cancer treatment toxicity and may improve outcomes for older patients with advanced cancer.

Read the detailed description

PRIMARY OBJECTIVES:

  1. To determine if providing information regarding geriatric assessment (GA) and GA-driven recommendations to oncology physicians reduces clinician-rated grade 3-5 toxicity in patients aged 70 and over with advanced cancer starting a new treatment regimen.

SECONDARY OBJECTIVES:

  1. Proportion of patients who are alive at 6 months after study entry. II. Evaluate whether providing oncology physicians with information regarding GA summary and GA-driven recommendations influences clinical care of older patients receiving treatment for advanced cancer.

IIA. Compare treatment decisions (as measured by relative dose intensity of the agents administered in the first cycle).

IIB. Describe the number and type of GA-driven recommendations implemented for older patients starting a new treatment regimen for advanced cancer.

OUTLINE: Treatment sites are randomized to 1 of 2 arms.

ARM I (GA intervention): Patients complete a geriatric assessment. Patients and physicians are provided with the geriatric assessment information and recommendations.

ARM II (usual care): Patients complete a geriatric assessment, but information other than clinically significant cognitive impairment and depression is not provided to the oncology teams.

After completion of study, patients are followed up at 4-6 weeks, at 3 and 6 months, and at 1 year.

Being tested
Comprehensive Geriatric Assessment, Quality-of-Life Assessment, Survey Administration
Medical subject headings
Lymphoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Comprehensive Geriatric AssessmentOther

    Also called geriatric assessment

    Complete geriatric assessment

  • Quality-of-Life AssessmentOther

    Also called Quality of Life Assessment

    Ancillary studies

  • Survey AdministrationOther

    Ancillary studies

Study groups in NCT02054741
Study groupRoleWhat they receive
Arm I (GA intervention)ExperimentalPatients complete a geriatric assessment. Patients and physicians are provided with the geriatric assessment information and recommendations.
Receives: Other: Comprehensive Geriatric Assessment; Other: Quality-of-Life Assessment; Other: Survey Administration
Arm II (usual care)No interventionPatients complete a geriatric assessment, but information other than clinically significant cognitive impairment and depression is not provided to the oncology teams.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Patient Experienced Any Grade 3-5 Toxicity

    Proportion of patients who experienced grade 3-5 toxicity within 3 months of initiation of new treatment regimen. Toxicity was graded according to the National Cancer Institute (NCI) CTCAE version (v)4.0.

    Measured: 3 months

Secondary outcomes (10)
  1. Patient Survival at 6 Months

    Proportion of patients who were alive at 6 months (183 days) after enrollment estimated by Kaplan-Meier method.

    Measured: 6 months

  2. Reduced Dose Intensity

    Proportion of patients with reduced dose intensity in cycle 1.

    Measured: 4-6 weeks

  3. GA-driven Recommendations Made Among Patients With Impaired Physical Performance.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired physical performance and starting a new treatment regimen for advanced cancer. Physical Performance measures included: Timed Up and Go, Short Physical Performance Battery, Falls History, and OARS Physical Health.

    Measured: Baseline

  4. GA-driven Recommendations Made Among Patients With Impaired Functional Status.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired functional status and starting a new treatment regimen for advanced cancer. Functional Status measures included: Activities of Daily Living and Instrumental Activities of Daily Living.

    Measured: Baseline

  5. GA-driven Recommendations Made Among Patients With Impaired Comorbidities.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired comorbidities and starting a new treatment regimen for advanced cancer. Comorbidity measure included: OARS Comorbidity.

    Measured: Baseline

  6. GA-driven Recommendations Made Among Patients With Impaired Cognition.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired cognition and starting a new treatment regimen for advanced cancer. Cognition measures included: Blessed Orientation Memory Concentration and Mini Cog assessments.

    Measured: Baseline

  7. GA-driven Recommendations Made Among Patients With Impaired Nutrition.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired nutrition and starting a new treatment regimen for advanced cancer. Nutrition measures included: Body Mass Index, Weight Loss, and Mini Nutrition Assessment.

    Measured: Baseline

  8. GA-driven Recommendations Made Among Patients With Impaired Social Support.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired social support and starting a new treatment regimen for advanced cancer. Social Support measure included: OARS Medical Social Support.

    Measured: Baseline

  9. GA-driven Recommendations Made Among Patients With Impaired Polypharmacy.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired polypharmacy and starting a new treatment regimen for advanced cancer. Polypharmacy measure included: medication review.

    Measured: Baseline

  10. GA-driven Recommendations Made Among Patients With Impaired Psychological Status.

    The type and frequency of GA-driven recommendations implemented for older patients with impaired psychological status and starting a new treatment regimen for advanced cancer. Psychological measures included: Geriatric Depression Scale and Generalized Anxiety Disorder - 7 item scale.

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Feb 2014 (estimated)
  2. Study start29 Jul 2014
  3. Primary completion31 Oct 2021
  4. Study completion31 Oct 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
733 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02054741
Sponsor's protocol ID
URCC13059
Other IDs
NCI-2013-01904, URCC13059, URCC-13059, URCC-13059, UG1CA189961, U10CA037420, R01CA177592
Status last verified
Apr 2024
First submitted
31 Jan 2014
Last updated
12 Apr 2024
Data monitoring committee
Yes

Publications

  • Mattick LJ, Mohammed M, Li CS, Tylock RG, Loh KP, Flannery MA, Peppone LJ, Lin PJ, Goncalves MD, Caan BJ, Cespedes Feliciano EM, Popuri K, Beg MF, Bearden JD, Berenberg J, Katato K, Mustian KM, Mohile SG, Dunne RF. Sarcopenia Is Associated With Severe Treatment Toxicity and Mortality in Older Adults With Advanced Cancer: A Secondary Analysis. J Cachexia Sarcopenia Muscle. 2026 Oct;17(5):e70388. doi: 10.1002/jcsm.70388.

    PubMed 42782098
  • Mohamed MR, Rich DQ, Lund JL, Seplaki CL, Flannery M, Alieldin R, Chen Y, Ramsdale E, Wells M, Magnuson A, Loh KP, Dunne R, Janelsins M, Mohile S. Treatment Tolerability in Older Adults With Advanced Cancer Receiving Geriatric Assessment-Guided Versus Oncologist-Guided Primary Treatment Modification: Secondary Analysis of the GAP70+ Trial. JCO Oncol Pract. 2026 Jul 24:OP2501364. doi: 10.1200/OP-25-01364. Online ahead of print.

    PubMed 42497369
  • Richardson DR, Wang Y, Flannery M, Mohamed M, Magnuson A, Wells M, Tylock R, Soto-Perez-de-Celis E, DuMontier C, Dale W, Epstein R, Berenberg J, Ramdin N, Mohile S, Loh KP. Outcomes of Older Adults With Advanced Cancer Who Prefer Quality of Life vs Prolonging Survival: A Secondary Analysis of the GAP70+ Cluster Randomized Clinical Trial. JAMA Oncol. 2026 May 1;12(5):517-521. doi: 10.1001/jamaoncol.2026.0072.

    PubMed 41784985
  • Hryniv S, Gilbride E, Consagra W, Mohile S, Yilmaz S, Kyi K, Kadambi S, Jensen-Battaglia M, Gilmore N, Whitehead M, Khatri J, Braiteh FS, Conlin A, Loh KP, Magnuson A. Exploring decisional control preferences in older patients with cancer and their caregivers. J Geriatr Oncol. 2026 Mar;17(2):102832. doi: 10.1016/j.jgo.2025.102832. Epub 2025 Dec 12.

    PubMed 41389716
  • Flannery MA, Zhang Z, Culakova E, Loh KP, Canin B, Tylock RG, Stauffer FA, Mohamed M, Sun H, Mohile S. Decision regret in older adults with advanced cancer receiving systemic therapy: Associations with patient-reported and clinician-rated tolerability metrics. Cancer. 2025 Oct 15;131 Suppl 2(Suppl 2):e70023. doi: 10.1002/cncr.70023.

    PubMed 41123568
  • Jensen-Battaglia M, Delmerico A, Mohamed M, Tylock R, Flannery M, Burnette BL, Desai N, Anthony N, Mustian K, Loh KP, Mohile SG, Seplaki CL, Gilmore N. Fatigue, physical function, and the context of social vulnerability for older adults with cancer. J Geriatr Oncol. 2025 Jul;16(6):102284. doi: 10.1016/j.jgo.2025.102284. Epub 2025 May 31.

    PubMed 40450795
  • Ramsdale E, Zhou Y, Smith L, Xu H, Tylock R, Flannery M, Mohile S, Anand A. Unsupervised learning to identify symptom clusters in older adults undergoing chemotherapy. J Geriatr Oncol. 2025 Apr;16(3):102222. doi: 10.1016/j.jgo.2025.102222. Epub 2025 Mar 14.

    PubMed 40088865
  • Mohamed MR, Juba K, Awad H, Flannery M, Culakova E, Wells M, Cacciatore J, Jensen-Battaglia M, Mohile S, Ramsdale E. Effect of polypharmacy and potentially inappropriate medications on physical functional decline among older adults with advanced cancer receiving systemic treatment. Support Care Cancer. 2024 Sep 19;32(10):674. doi: 10.1007/s00520-024-08877-6.

    PubMed 39294452
  • Lund JL, Cacciatore J, Tylock R, Su IH, Sharma S, Hinton SP, Smith S, Nowels MA, Chen X, Duberstein PR, Hanson LC, Mohile SG. Development and Evaluation of a Multisource Approach to Extend Mortality Follow-Up for Older Adults With Advanced Cancer Enrolled in Randomized Trials. JCO Clin Cancer Inform. 2024 Apr;8:e2300183. doi: 10.1200/CCI.23.00183.

    PubMed 38564692
  • Ramsdale E, Kunduru M, Smith L, Culakova E, Shen J, Meng S, Zand M, Anand A. Supervised learning applied to classifying fallers versus non-fallers among older adults with cancer. J Geriatr Oncol. 2023 May;14(4):101498. doi: 10.1016/j.jgo.2023.101498. Epub 2023 Apr 19.

    PubMed 37084629
  • Xu H, Mohamed M, Flannery M, Peppone L, Ramsdale E, Loh KP, Wells M, Jamieson L, Vogel VG, Hall BA, Mustian K, Mohile S, Culakova E. An Unsupervised Machine Learning Approach to Evaluating the Association of Symptom Clusters With Adverse Outcomes Among Older Adults With Advanced Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2023 Mar 1;6(3):e234198. doi: 10.1001/jamanetworkopen.2023.4198.

    PubMed 36947036
  • Mohamed MR, Loh KP, Mohile SG, Sohn M, Webb T, Wells M, Yilmaz S, Tylock R, Culakova E, Magnuson A, Sun CL, Bearden J, Hopkins JO, Faller BA, Klepin HD. External Validation of Risk Factors for Unplanned Hospitalization in Older Adults With Advanced Cancer Receiving Chemotherapy. J Natl Compr Canc Netw. 2023 Mar;21(3):273-280.e3. doi: 10.6004/jnccn.2022.7094.

    PubMed 36898361
  • Mohamed MR, Mohile SG, Juba KM, Awad H, Wells M, Loh KP, Flannery M, Culakova E, Tylock RG, Ramsdale EE. Association of polypharmacy and potential drug-drug interactions with adverse treatment outcomes in older adults with advanced cancer. Cancer. 2023 Apr 1;129(7):1096-1104. doi: 10.1002/cncr.34642. Epub 2023 Jan 24.

    PubMed 36692475
  • Culakova E, Mohile SG, Peppone L, Ramsdale E, Mohamed M, Xu H, Wells M, Tylock R, Java J, Loh KP, Magnuson A, Jamieson L, Vogel V, Duberstein PR, Chapman BP, Dale W, Flannery MA. Effects of a Geriatric Assessment Intervention on Patient-Reported Symptomatic Toxicity in Older Adults With Advanced Cancer. J Clin Oncol. 2023 Feb 1;41(4):835-846. doi: 10.1200/JCO.22.00738. Epub 2022 Nov 10.

    PubMed 36356279
  • Presley CJ, Mohamed MR, Culakova E, Flannery M, Vibhakar PH, Hoyd R, Amini A, VanderWalde N, Wong ML, Tsubata Y, Spakowicz DJ, Mohile SG. A Geriatric Assessment Intervention to Reduce Treatment Toxicity Among Older Adults With Advanced Lung Cancer: A Subgroup Analysis From a Cluster Randomized Controlled Trial. Front Oncol. 2022 Mar 31;12:835582. doi: 10.3389/fonc.2022.835582. eCollection 2022.

    PubMed 35433441

Questions about this trial

What is this clinical trial studying?

A study testing Comprehensive Geriatric Assessment, Quality-of-Life Assessment and Survey Administration in people with Adult Solid Neoplasm and Toxicity, run by Supriya Mohile at 23 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Jun 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Patient Experienced Any Grade 3-5 Toxicity (time frame: 3 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02054741, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Apr 2024.

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