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Hoang T, Timilshina N, Habib MH, Jin R, Monginot S, Berger A, Romanovsky L, Norman R, Alibhai SMH. Implementation of clinical recommendations from the geriatric oncology clinic. J Geriatr Oncol 2023; 14:101534. [PMID: 37229883 DOI: 10.1016/j.jgo.2023.101534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/25/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION While evidence on the value of routine geriatric assessment (GA) in cancer care for older patients is growing, there is limited data on the geriatric oncology (GO) clinic's specific recommendations and how they are implemented. In this study, we aimed to assess and evaluate the implementation of recommendations from the GO clinic at Princess Margaret Cancer Center, Toronto, Canada, within six months of the initial visit. MATERIALS AND METHODS A retrospective chart review was conducted on 100 consecutive adults age 65+ visiting the GO clinic from 2018 to 2019. For each patient, we evaluated the number and type of recommendations from the GO clinic. Recommendations were grouped based on clinical judgement. Of the recorded recommendations, we measured the rate of implementation within six months of the initial visit including who implemented the recommendations and why recommendations were not implemented. Data were analyzed using descriptive statistics. RESULTS One hundred patients visiting the GO clinic (mean age of 80.5 years, 62% male, 52% with planned curative intent, with the genitourinary site being most common) received a median of six recommendations (range of 2-12), regardless of sex, cancer stage, cancer site, and treatment intent. Medication optimization (27%), patient education (26%), and referral to allied health (14%) were the top recommendations from the GO clinic. At six-month follow-up, 83% of all recommendations were implemented, of which 94% were performed by the GO clinic team. Patient education was implemented at a 100% rate by the GO clinic at the time of initial assessment. GO follow-up visit and other diagnostic tests (hearing test, vision test) were the recommendations with the lowest implementation rates, at 51% and 31%, respectively. The most common reasons for recommendations not being implemented were patient transfer to palliative care/death and patient declining recommendations due to busy appointment schedules. DISCUSSION A median of six recommendations were made per patient. The vast majority of recommendations were implemented, predominantly by the GO team. Overall, the study helps evaluate recommendations provided to patients visiting GO clinics, identify potential gaps, and assist with resource planning for optimal cancer care for older adults.
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Affiliation(s)
- Tuan Hoang
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | - Rana Jin
- Department of Nursing, University Health Network, Toronto, ON, Canada
| | - Susie Monginot
- Department of Nursing, University Health Network, Toronto, ON, Canada
| | - Arielle Berger
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Lindy Romanovsky
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Richard Norman
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Shabbir M H Alibhai
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, University Health Network, Toronto, ON, Canada.
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Deldycke A, Denys H, Decruyenaere A, Velghe A, Naert E. Clinical decision-making in older patients with cancer: a cross-sectional single-centre study to assess the impact of clinical judgement and patient preferences. Acta Clin Belg 2023; 78:103-111. [PMID: 36879530 DOI: 10.1080/17843286.2022.2074702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The heterogeneity in the population of older patients with cancer makes clinical decision-making difficult. We investigated the agreement between the G8 score and clinical judgment in frailty assessments, determined the impact of a life-expectancy calculator, and explored patient and caregiver preferences towards the treatment goal. METHODS Patients aged ≥75 years in need of new oncological treatment were prospectively enrolled between June 2020 and February 2021. Frailty was estimated by the oncologist and caregiver and compared to the G8 estimation. We examined whether the oncologist changed the fit/frail estimation based on life expectancy calculated using the ePrognosis tool. The main treatment goals, either longevity or quality of life (QoL), from the patient's and caregiver's perspective were noted and compared. RESULTS Forty-nine patients were included in the analysis. Comparison of the oncologist's and the caregiver's frailty estimation with the G8 assessment showed agreement and a Kappa coefficient of 58.3% (0.231) and 60% (0.255), respectively. The ePrognosis score and the odds of change in the frailty estimation by the oncologist showed no correlation. Regarding preferences, 28 (57.1%) and 17 (34.7%) patients and eighteen (47.3%) and seventeen (44.7%) caregivers chose longevity and QoL, respectively. The observed agreement and Kappa coefficient were 78.8% and 0.578. CONCLUSION Compared to the G8 assessment, frailty was underestimated by both oncologists and caregivers. Most of the patients chose longevity over QoL, and the preferences between the patient and the caregiver matched in the majority of cases.
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Affiliation(s)
- Annelies Deldycke
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Hannelore Denys
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | | | - Anja Velghe
- Geriatrics Department, Ghent University Hospital, Ghent, Belgium
| | - Eline Naert
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
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Boulahssass R, Chand ME, Gal J, Dittlot C, Schiappa R, Rambaud C, Gonfrier S, Guerin O, Hannoun-Levi JM. Quality of life and Comprehensive Geriatric Assessment (CGA) in older adults receiving Accelerated Partial Breast Irradiation (APBI) using a single fraction of Multi-Catheter Interstitial High-Dose Rate Brachytherapy (MIB). The SiFEBI phase I/II trial. J Geriatr Oncol 2021; 12:1085-1091. [PMID: 33994151 DOI: 10.1016/j.jgo.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/01/2021] [Accepted: 04/30/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The SiFEBI trial demonstrated that a post-operative Multicatheter Interstitial Brachytherapy (MIB) appears feasible and with acceptable toxicity in older adults aged 70 years and older presenting with low-risk breast cancer. The aim of the present ancillary study was to analyze the quality of life and Comprehensive Geriatric Assessment (CGA) domains within 6 months in older adults receiving Accelerated Partial Breast Irradiation (APBI) using a single fraction of MIB. MATERIALS AND METHODS From 11/2012 to 09/2014, 37 patients were included and 26 were evaluable. Patients (pts) aged 70 years and older with a Balducci score of 1 or 2 and presenting with low-risk breast cancer were prospectively enrolled in this phase I/II trial (NCT01727011). After lumpectomy, intra-operative catheter implantation was performed for post-operative APBI after pathological findings. Quality of life (QoL) evaluation and CGA were scheduled at baseline and 1, 3, and 6 months after APBI. Autonomy decline was defined as a 1-point decrease in Activities of Daily Living (ADL). RESULTS Mean age was 77 years. Within the first 6 months of follow-up, no autonomy decline was observed in ADL, 3 patients had an autonomy decline in Instrumental Activities of Daily Living (IADL) and 2 patients had a slower gait speed but no changes in cognitive function, nutritional status, and depression screening. Global QoL was quite similar at baseline compared to 1, 3, and 6 months. No differences were observed for functional items. CONCLUSION APBI based on a single fraction of MIB in older adults with low-risk breast cancer appears to be feasible with a minimal loss of autonomy regarding IADL, no loss of autonomy in ADL, an acceptable decrease in other CGA domains, and with no impact on global quality of life.
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Affiliation(s)
- Rabia Boulahssass
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France; FHU ONCOAGE, Nice, France; University of Nice-Sophia Antipolis, France.
| | | | - Jocelyn Gal
- University of Nice-Sophia Antipolis, France; Epidemiology and Biostatistics Department, Lacassagne Center, Nice, France
| | - Claire Dittlot
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France; Department of Surgical Oncology, Lacassagne Center, Nice, France
| | - Renaud Schiappa
- University of Nice-Sophia Antipolis, France; Epidemiology and Biostatistics Department, Lacassagne Center, Nice, France
| | - Cyrielle Rambaud
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France
| | - Sebastien Gonfrier
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France
| | - Olivier Guerin
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), PACA Est CHU de NICE, France; FHU ONCOAGE, Nice, France; University of Nice-Sophia Antipolis, France
| | - Jean Michel Hannoun-Levi
- University of Nice-Sophia Antipolis, France; Department of Radiotherapy, Lacassagne Center, Nice, France
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Kadambi S, Loh KP, Dunne R, Magnuson A, Maggiore R, Zittel J, Flannery M, Inglis J, Gilmore N, Mohamed M, Ramsdale E, Mohile S. Older adults with cancer and their caregivers - current landscape and future directions for clinical care. Nat Rev Clin Oncol 2020; 17:742-755. [PMID: 32879429 PMCID: PMC7851836 DOI: 10.1038/s41571-020-0421-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 12/13/2022]
Abstract
Despite substantial improvements in the outcomes of patients with cancer over the past two decades, older adults (aged ≥65 years) with cancer are a rapidly increasing population and continue to have worse outcomes than their younger counterparts. Managing cancer in this population can be challenging because of competing health and ageing-related conditions that can influence treatment decision-making and affect outcomes. Geriatric screening tools and comprehensive geriatric assessment can help to identify patients who are most at risk of poor outcomes from cancer treatment and to better allocate treatment for these patients. The use of evidence-based management strategies to optimize geriatric conditions can improve communication and satisfaction between physicians, patients and caregivers as well as clinical outcomes in this population. Clinical trials are currently underway to further determine the effect of geriatric assessment combined with management interventions on cancer outcomes as well as the predictive value of geriatric assessment in the context of treatment with contemporary systemic therapies such as immunotherapies and targeted therapies. In this Review, we summarize the unique challenges of treating older adults with cancer and describe the current guidelines as well as investigational studies underway to improve the outcomes of these patients.
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Affiliation(s)
- Sindhuja Kadambi
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA.
| | - Kah Poh Loh
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Richard Dunne
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Allison Magnuson
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Ronald Maggiore
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Jason Zittel
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Marie Flannery
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Julia Inglis
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Nikesha Gilmore
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Mostafa Mohamed
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Erika Ramsdale
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA
| | - Supriya Mohile
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Haematology/Oncology, Rochester, NY, USA.
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Farrington N, Richardson A, Bridges J. Interventions for older people having cancer treatment: A scoping review. J Geriatr Oncol 2020; 11:769-783. [DOI: 10.1016/j.jgo.2019.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 07/24/2019] [Accepted: 09/25/2019] [Indexed: 01/05/2023]
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Carrier P, Debette-Gratien M, Jacques J, Loustaud-Ratti V. Cirrhotic patients and older people. World J Hepatol 2019; 11:663-677. [PMID: 31598192 PMCID: PMC6783402 DOI: 10.4254/wjh.v11.i9.663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/18/2019] [Accepted: 07/16/2019] [Indexed: 02/06/2023] Open
Abstract
The global population is aging, and so the number of older cirrhotic patients is increasing. Older patients are characterised by a risk of frailty and comorbidities, and age is a risk factor for mortality in cirrhotic patients. The incidence of non-alcoholic fatty liver disease as an aetiology of cirrhosis is increasing, while that of chronic viral hepatitis is decreasing. Also, cirrhosis is frequently idiopathic. The management of portal hypertension in older cirrhotic patients is similar to that in younger patients, despite the greater risk of treatment-related adverse events of the former. The prevalence of hepatocellular carcinoma increases with age, but its treatment is unaffected. Liver transplantation is generally recommended for patients < 70 years of age. Despite the increasing prevalence of cirrhosis in older people, little data are available and few recommendations have been proposed. This review suggests that comorbidities have a considerable impact on older cirrhotic patients.
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Affiliation(s)
- Paul Carrier
- Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
- Faculté de Médecine et de Pharmacie de Limoges, Rue Docteur Marcland, Limoges 87042, France
| | - Marilyne Debette-Gratien
- Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
- Faculté de Médecine et de Pharmacie de Limoges, Rue Docteur Marcland, Limoges 87042, France
| | - Jérémie Jacques
- Service de Gastroentérologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
| | - Véronique Loustaud-Ratti
- Fédération d’Hépatologie, Centre Hospitalier Universitaire Dupuytren de Limoges, Limoges 87042, France
- Faculté de Médecine et de Pharmacie de Limoges, Rue Docteur Marcland, Limoges 87042, France.
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Overcash J, Ford N, Kress E, Ubbing C, Williams N. Comprehensive Geriatric Assessment as a Versatile Tool to Enhance the Care of the Older Person Diagnosed with Cancer. Geriatrics (Basel) 2019; 4:geriatrics4020039. [PMID: 31238518 PMCID: PMC6630523 DOI: 10.3390/geriatrics4020039] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/14/2019] [Accepted: 06/20/2019] [Indexed: 12/27/2022] Open
Abstract
The comprehensive geriatric assessment (CGA) is a versatile tool for the care of the older person diagnosed with cancer. The purpose of this article is to detail how a CGA can be tailored to Ambulatory Geriatric Oncology Programs (AGOPs) in academic cancer centers and to community oncology practices with varying levels of resources. The Society for International Oncology in Geriatrics (SIOG) recommends CGA as a foundation for treatment planning and decision-making for the older person receiving care for a malignancy. A CGA is often administered by a multidisciplinary team (MDT) composed of professionals who provide geriatric-focused cancer care. CGA can be used as a one-time consult for surgery, chemotherapy, or radiation therapy providers to predict treatment tolerance or as an ongoing part of patient care to manage malignant and non-malignant issues. Administrative support and proactive infrastructure planning to address scheduling, referrals, and provider communication are critical to the effectiveness of the CGA.
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Affiliation(s)
- Janine Overcash
- The College of Nursing, The Ohio State University, 1585 Neil Ave, Newton Hall, Columbus, OH 43201, USA.
| | - Nikki Ford
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Elizabeth Kress
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Caitlin Ubbing
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
| | - Nicole Williams
- Stephanie Spielman Comprehensive Breast Center, The Ohio State University, 1145 Olentangy River Road, Columbus, OH 43121, USA.
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Hofman P, Ayache N, Barbry P, Barlaud M, Bel A, Blancou P, Checler F, Chevillard S, Cristofari G, Demory M, Esnault V, Falandry C, Gilson E, Guérin O, Glaichenhaus N, Guigay J, Ilié M, Mari B, Marquette CH, Paquis-Flucklinger V, Prate F, Saintigny P, Seitz-Polsky B, Skhiri T, Van Obberghen-Schilling E, Van Obberghen E, Yvan-Charvet L. The OncoAge Consortium: Linking Aging and Oncology from Bench to Bedside and Back Again. Cancers (Basel) 2019; 11:E250. [PMID: 30795607 PMCID: PMC6406685 DOI: 10.3390/cancers11020250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 01/04/2023] Open
Abstract
It is generally accepted that carcinogenesis and aging are two biological processes, which are known to be associated. Notably, the frequency of certain cancers (including lung cancer), increases significantly with the age of patients and there is now a wealth of data showing that multiple mechanisms leading to malignant transformation and to aging are interconnected, defining the so-called common biology of aging and cancer. OncoAge, a consortium launched in 2015, brings together the multidisciplinary expertise of leading public hospital services and academic laboratories to foster the transfer of scientific knowledge rapidly acquired in the fields of cancer biology and aging into innovative medical practice and silver economy development. This is achieved through the development of shared technical platforms (for research on genome stability, (epi)genetics, biobanking, immunology, metabolism, and artificial intelligence), clinical research projects, clinical trials, and education. OncoAge focuses mainly on two pilot pathologies, which benefit from the expertise of several members, namely lung and head and neck cancers. This review outlines the broad strategic directions and key advances of OncoAge and summarizes some of the issues faced by this consortium, as well as the short- and long-term perspectives.
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Affiliation(s)
- Paul Hofman
- Laboratory of Clinical and Experimental Pathology/Biobank 0033-00025, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06001 Nice, France.
- Inserm U1081, CNRS UMR7284, Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), FHU OncoAge, Université Côte d'Azur, 06107 Nice, France.
| | - Nicholas Ayache
- Epione Team, Inria, FHU OncoAge, Université Côte d'Azur, 06902 Sophia Antipolis, France.
| | - Pascal Barbry
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
| | - Michel Barlaud
- i3S Sophia Antipolis, FHU OncoAge, Université Côte d'Azur, 06560 Sophia Antipolis, France.
| | - Audrey Bel
- Centre d'Innovation et d'Usages en Santé (CIUS), FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Philippe Blancou
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
| | - Frédéric Checler
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
| | - Sylvie Chevillard
- Laboratoire de Cancérologie Expérimentale, Institut François Jacob, CEA Direction de la Recherche Fondamentale, FHU OncoAge, Université Côte d'Azur, 92265 Fontenay-aux-Roses, France.
| | - Gael Cristofari
- Inserm U1081, CNRS UMR7284, Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), FHU OncoAge, Université Côte d'Azur, 06107 Nice, France.
| | - Mathilde Demory
- Ville de Nice, Mairie de Nice, FHU OncoAge, Université Côte d'Azur, 06364 Nice, France.
| | - Vincent Esnault
- Nephrology Department, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06001 Nice, France.
| | - Claire Falandry
- Geriatric Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, FHU OncoAge, Université Claude Bernard Lyon 1, 69310 Pierre-Benite, France.
- Laboratoire CarMeN, Inserm U1060, INRA U139, INSA Lyon, Ecole de Médecine Charles Mérieux, Université Claude Bernard Lyon 1, 69921 Oullins, France.
| | - Eric Gilson
- Inserm U1081, CNRS UMR7284, Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), FHU OncoAge, Université Côte d'Azur, 06107 Nice, France.
| | - Olivier Guérin
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Nicolas Glaichenhaus
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
| | - Joel Guigay
- Oncology Department, Centre Antoine Lacassagne, FHU OncoAge, Université Côté d'Azur, 06189 Nice, France.
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology/Biobank 0033-00025, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06001 Nice, France.
- Inserm U1081, CNRS UMR7284, Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), FHU OncoAge, Université Côte d'Azur, 06107 Nice, France.
| | - Bernard Mari
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
| | - Charles-Hugo Marquette
- Department of Pulmonary Medicine and Oncology, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Véronique Paquis-Flucklinger
- Inserm U1081, CNRS UMR7284, Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), FHU OncoAge, Université Côte d'Azur, 06107 Nice, France.
| | - Frédéric Prate
- Geriatric Coordination Unit for Geriatric Oncology (UCOG) PACA Est, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | - Pierre Saintigny
- Département de Médecine, INSERM 1052, CNRS 5286, Centre de recherche en cancérologie de Lyon, Centre Léon Bérard, FHU OncoAge, Université Claude Bernard Lyon 1, 69008 Lyon, France.
| | - Barbara Seitz-Polsky
- CNRS UMR7275, Institut de Pharmacologie Cellulaire et Moléculaire, FHU OncoAge, Université Côte d'Azur, 06560 Valbonne, France.
- Laboratory of Immunology, CHU Nice, FHU OncoAge, Université Côte d'Azur, 06200 Nice, France.
| | - Taycir Skhiri
- Centre d'Innovation et d'Usages en Santé (CIUS), FHU OncoAge, Université Côte d'Azur, 06000 Nice, France.
| | | | | | - Laurent Yvan-Charvet
- Inserm U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), FHU OncoAge, Université Côte d'Azur, 06200 Nice, France.
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