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Genomic prognosis and predictive tools for elderly cancer patients

Standard prognostic and predictive tools are historically based on pathological and clinical information. However most of them have been generally developed in standard adult populations, including only a limited number of older patients; thus they often have proven to be inadequate when extrapolated to the elderly cancer population. This is recently best exemplified by the Adjuvant!Online model which overestimates by 10% the 10-year overall survival of older women with breast cancer. There is considerable hope and expectation that tumour gene expression profiles may assess more closely prognosis and potential benefit of treatments, thus improving the use of health care resources. However evaluating their role in the elderly cancer population requires specific data, considering also competing risks for mortality which increase according to age and vary greatly across tumour types. Different geriatric scores exist that may help to predict short-term and long-term prognosis; geriatric evaluation too remains a key component to approach functional declines, since these later may jeopardize the benefit sought with any treatment, when geriatric considerations are not integrated to the general therapeutic decision making process.

Aims
to review the available evidence showing that new genomic expression profiles and signatures may help to better estimate prognosis and adapt treatments to older patients with breast, colorectal and prostate cancers. Unpublished data could also be taken into consideration.

Task Force Members

Moderators:
Etienne Brain, France & Christos Sotiriou, Belgium

Writing Committee
Nigel Bundred, United Kingdom
Margot Gosney, United Kingdom
Regina Girones Sarrio, Spain
Berta Sousa, Portugal
Sabine Tejpar, France

2015 06 - a first Task Force meeting was organised.

This project is supported by an unrestricted grants from Agendia and Genomic Health.