INTRODUCTION: Colorectal carcinoma predominantly affects older adults (defined as ≥75 years). A proportion of these patients are frail and have multimorbidity, reflecting multidimensional vulnerability related to comorbi...INTRODUCTION: Colorectal carcinoma predominantly affects older adults (defined as ≥75 years). A proportion of these patients are frail and have multimorbidity, reflecting multidimensional vulnerability related to comorbidities and functional status. These factors complicate treatment decisions, especially regarding surgical interventions and systemic therapies. In response, a multidisciplinary clinical care pathway was established at Catharina Hospital in 2021 to facilitate individualized treatment management for older and frail patients with colorectal cancer. This pathway was led by physicians from multiple medical specialties, including surgery, medical oncology, radiation oncology, and geriatrics, and incorporated a comprehensive geriatric assessment. This study aimed to assess how the multidisciplinary care pathway influences treatment decisions in older and frail patients with colorectal cancer. MATERIALS AND METHODS: In this retrospective cohort study, patients evaluated through the multidisciplinary care pathway between October 2021 and March 2025 were compared with a propensity score-matched control group treated prior to its implementation, between December 2018 and September 2021. The primary outcome was the deviation between the standard treatment protocol and the actual treatment received by the patient. Secondary outcomes were treatment-related complications, hospitalizations, overall survival, and local disease control. RESULTS: Treatment deviation occurred more frequently in the care pathway group (51.4%) compared to the pre-care pathway group (31.1%; p = 0.01). Reasons for deviation from standard treatment included patient vulnerability and patient treatment preferences. Patients managed through the care pathway experienced fewer treatment related surgical complications (25.7% vs. 46.2%; p = 0.002) and lower hospital admission rates (49.1% vs. 72.4%; p = 0.002). In both cohorts, an American Society of Anesthesiologists Physical Status Classification ≥3 (p = 0.02 in the pre-care and p < 0.001 in the care pathway cohort) and dependent mobility (p = 0.004 and p < 0.001, respectively) predicted deviation from standard treatment. Additionally, within the care pathway cohort, Clinical Frailty Scale score ≥ 5 (p = 0.03), impaired instrumental activities of daily living (p = 0.02), Katz Index of Independence in Activities of Daily Living >1 (p = 0.01), and competing mortality risk (pl ≤0.001) were also significantly associated with treatment deviations. DISCUSSION: Implementation of a multidisciplinary care pathway for older and frail patients with colorectal cancer led to more individualized treatment decisions, reduced treatment-related complications, and reduced hospital stays. Future research is needed to optimize patient selection for this multidisciplinary care pathway.
INTRODUCTION: Implementation of prehabilitation for patients undergoing surgical treatment for colon cancer has proven effective in reducing the risk of postoperative complications. Currently the recommended maximal trea...INTRODUCTION: Implementation of prehabilitation for patients undergoing surgical treatment for colon cancer has proven effective in reducing the risk of postoperative complications. Currently the recommended maximal treatment interval has limited span for implementation of a prehabilitation program. The aim of the current study was to determine the association between advised treatment interval and (cancer-free) survival, while stratifying for the risk of postoperative complications. MATERIALS AND METHODS: This retrospective multicenter study included patients who underwent elective surgical treatment for colon cancer between 2010 and 2016. Patients were stratified based on risk of postoperative complications (high-risk and non-high-risk). Treatment interval was defined as time between diagnosis and surgery, divided into three categories (≤35 days, 36-49 days, and > 49 days). Primary endpoints were overall survival and cancer-free survival, assessed by multivariate Cox proportional hazard regression analysis. RESULTS: A total of 3376 patients were included, of whom 60% were considered non-high-risk and 40% high-risk, with a median age of 72 years (IQR 64-78). Of the included patients, 862 (26%) had tumor stage I, 1353 (40%) had tumor stage II, and 1160 (34%) had tumor stage III colon cancer. Treatment interval was not associated with cancer-free survival (36-49 days [non-high-risk p = 0.77; high-risk p = 0.56] or > 49 days [non-high-risk p = 0.46; high-risk p = 0.13]). A treatment interval > 49 days was associated with poorer five-year overall survival in non-high-risk patients (HR = 1.35, p < 0.05), but not in high-risk patients (p = 0.69). A treatment interval of 36-49 days was not associated with five-year overall survival (non-high-risk p = 0.24; high-risk p = 0.98). DISCUSSION: Extending the treatment interval in curative treatment of colon cancer up to 49 days appears safe for both high-risk and non-high-risk patients. For high-risk patients, the expected benefits of longer treatment interval including prehabilitation should be balanced with the medical urgency to operate.
INTRODUCTION: In older adults with cancer, geriatric assessment (GA) can improve care quality. In-person assessment may not be feasible for all patients, and relevant information already exists in electronic health recor...INTRODUCTION: In older adults with cancer, geriatric assessment (GA) can improve care quality. In-person assessment may not be feasible for all patients, and relevant information already exists in electronic health record (EHRs). However, chart review is time-consuming. Recently, large language models (LLMs) have demonstrated potential for automated abstraction and summarization tasks. The purpose of this study was to (1) develop an approach using LLMs to identify GA domains, and (2) demonstrate the potential of LLMs for creating GA summaries. MATERIALS AND METHODS: We extracted notes in the month following a poor prognosis for 30 randomly selected patients with cancer across seven clinical sites. We used a HIPAA-secure artificial intelligence tool to develop LLM prompts to identify and summarize domains. LLM was compared to chart review. A "hallucination score" was calculated for text included in the output. A "hallucination" is the term used to describe the production of false evidence. RESULTS: Across 20 GA domains, note-level LLM analysis achieved sensitivity ranging from 0.44 to 1.0, specificity ranging 0.24-0.99, and accuracy ranging 0.49-0.98. Average hallucination index for documentation identified by the LLM was low. LLM frequently identified information that was documented in notes but missed by human experts. LLM-generated summaries included clinically-relevant information. DISCUSSION: LLMs can abstract information relevant to GA domains with performance that is comparable to chart review, and in a fraction of the time. Although it would be ideal for all patients to receive in-person GAs, LLMs can identify relevant information when this is not feasible. The LLM exhibited low rate of producing false evidence, addressing one of the main concerns about clinical applications. LLM-generated GA summaries represent the first automated approach for this task.
INTRODUCTION: Many older adults with a history of cancer do not meet diet or exercise recommendations, leading to suboptimal physical function. The E-PROOF study is the first synchronous, online, protein-focused dietary...INTRODUCTION: Many older adults with a history of cancer do not meet diet or exercise recommendations, leading to suboptimal physical function. The E-PROOF study is the first synchronous, online, protein-focused dietary and resistance training randomized controlled trial among older cancer survivors. This study determined the feasibility, acceptability, and exploratory intervention effects (improving physical function, diet quality, and exercise) over the 12-week intervention. MATERIALS AND METHODS: Eligibility criteria included adults age ≥ 65 years, with breast, colorectal, or prostate cancer, and completion of treatment with curative intent. Intervention participants received personalized nutrition counseling sessions and supervised resistance training sessions focused on increased protein intake and resistance training, respectively. Attentional control participants received counseling on stretching and general healthy eating. RESULTS: The participants (n = 75) were a median of 70 years old, 71% female, 82% non-Hispanic White, 73% breast cancer survivors, and they had a median of 8.97 years since primary cancer diagnosis. The program had an 83% retention rate (62/75 participants) and > 87% adherence rate for diet and exercise sessions. Participants reported high acceptability of the pilot intervention. Adjusted and unadjusted for age, race, sex, and cancer type, means for physical function significantly improved from baseline to the end-of-intervention in both groups (+0.5 change in the intervention arm and + 0.7 change in the attentional control arm for both models), but the change was not significantly different (p = 0.69). DISCUSSION: Findings from the E-PROOF study demonstrate its feasibility and acceptability among older post-treatment cancer survivors. This pilot study supports independent healthy behaviors, which can improve health outcomes and provide foundational knowledge to further address the growing population of older cancer survivors on a wider scale through online platforms.
INTRODUCTION: Geriatric oncology is a multi-disciplinary field that aims to provide optimal care for older patients with cancer. The review's objective was to comprehensively describe the clinical activities undertaken b...INTRODUCTION: Geriatric oncology is a multi-disciplinary field that aims to provide optimal care for older patients with cancer. The review's objective was to comprehensively describe the clinical activities undertaken by pharmacists in geriatric oncology, in both inpatient and outpatient settings, and to assess their potential impacts. MATERIALS AND METHODS: This systematic review was performed by two pharmacists according to PRISMA guidelines and SQUIRE checklist for the quality assessment. PubMed, EMBASE, and Web of Science databases were searched for studies written in English and French, published between 2010 and February 2024, that involved pharmacist-led interventions. Pharmaceutical care was analysed: description of activity and tools, pharmacist's impact, patient satisfaction, pharmaceutical interventions (PIs), medication safety, quality of life (Qol), disease outcome, or economic impact. The studies with no original format or off topic were excluded. RESULTS: Six hundred fifty-eight articles were identified; 18 were included. Study designs were heterogeneous: pilot, prevalence, implementation studies, and randomized clinical trials. Two activities are described: medication review (100%) and medication therapy management (22%). Pharmacist's impact has been analysed (61%) and a reduction in drug related problem was noticed (n = 8) ranging from 28 to 73%. Pharmacists' interventions were described (n = 12) and their acceptance was quantified (n = 7) ranging from 22 to 91%. Two studies reported an economic impact, three assessed patient satisfaction, and one demonstrated a reduction in chemotherapy toxicity by 10.1%. Qol was not impacted. DISCUSSION: The pharmacist's impact is measured by PIs' acceptance, patient satisfaction, or economic impact. A measure of impact on mortality or treatment tolerability seems necessary.
INTRODUCTION: Informal caregivers are essential to the care of older adults with cancer but may experience strain. We identified patient factors associated with burden in informal caregivers of older adults with cancer a...INTRODUCTION: Informal caregivers are essential to the care of older adults with cancer but may experience strain. We identified patient factors associated with burden in informal caregivers of older adults with cancer and described geriatric assessment (GA)-based recommendations for informal caregivers with burden. MATERIALS AND METHODS: This cross-sectional study included older adults (≥70 years) with cancer and a geriatric risk profile (G8 ≤ 14/17) from three centres in Belgium. All participants underwent a GA and received GA-based recommendations. Informal caregivers completed the 12-item Zarit Burden Interview (ZBI-12). Data were collected using a case report form. Logistic regression identified factors associated with significant caregiver burden (ZBI-12 ≥ 10). RESULTS: Between July 2012 and Jun 2015, of 900 eligible patients, 349 informal caregivers completed the ZBI-12; 149 (42.7%) reported significant caregiver burden (ZBI-12 ≥ 10). In univariate analysis, poorer Eastern Cooperative Oncology Group performance status (ECOG-PS 3-4; OR 2.27, 95% CI 1.41-3.70), higher activities of daily living (ADL) score (OR 1.09, 95% CI 1.02-1.15), longer Timed Up and Go test time (OR 1.04, 95% CI 1.00-1.07), higher patient fatigue score (OR 1.13, 95% CI 1.05-1.22), lower instrumental activities of daily living (iADL) score (OR 0.78, 95% CI 0.71-0.86), lower Mini-Mental State Examination score (OR 0.92, 95% CI 0.74-0.98), lower Mini Nutritional Assessment Short-Form score (OR 0.90, 95% CI 0.83-0.97), and greater comorbidity burden (OR 1.13, 95% CI 1.02-1.26) were associated with increased caregiver burden. In multivariable analysis, decreased iADL (OR 0.79, 95% CI 0.71-0.87) and increased patient fatigue (OR 1.11, 95% CI 1.02-1.19) were independent predictors of caregiver burden. Among informal caregivers with significant burden, the most common GA-based recommendations were nutritional counselling (113 [77.4%]) and medication adjustments (41 [28.1%]). DISCUSSION: Decreased ability to perform iADL and increased patient fatigue were independently associated with caregiver burden in older adults with cancer and should be considered in oncogeriatric assessment. GA-based recommendations, particularly nutritional support and medication review, provide actionable targets to support this population.
INTRODUCTION: Immune checkpoint inhibitors (ICIs) have transformed cancer treatment; however, their use in patients with pre-existing autoimmune diseases (PAD) remains controversial. This study evaluated the real-world s...INTRODUCTION: Immune checkpoint inhibitors (ICIs) have transformed cancer treatment; however, their use in patients with pre-existing autoimmune diseases (PAD) remains controversial. This study evaluated the real-world safety and effectiveness of ICIs in older adults with metastatic non-small cell lung cancer (mNSCLC) and PAD. MATERIALS AND METHODS: This retrospective cohort study used SEER-Medicare data to investigate individuals aged ≥66 years diagnosed with mNSCLC between 2015 and 2017, receiving either immunotherapy/chemoimmunotherapy (IT/CIT) or chemotherapy (CT). Outcomes were time to hospitalization due to serious immune-related adverse events (irAEs) and overall survival (OS). The treatment effects on outcomes were studied using Cumulative Incidence Function (CIF) plots, Kaplan-Meier curves, the Fine and Gray competing risk regression, and multivariable Cox regression analyses. Adjusted hazard ratios (aHRs) and 95% CIs were reported. RESULTS: This study involved 1319 older adults with mNSCLC and PAD; 22.3% received IT/CIT and 77.7% received CT. Baseline characteristics differed significantly between treatment groups. No significant difference in serious irAE-related hospitalization was observed between IT/CIT and CT (aHR = 1.06, 95% CI: 0.79-1.42; sensitivity analysis: aHR = 1.01, 95% CI: 0.70-1.45). For OS, among those with pre-existing rheumatoid arthritis (RA), no significant difference was found in the main analysis (aHR = 1.34, 95% CI: 0.94-1.92), though sensitivity analysis indicated higher mortality with IT/CIT (aHR = 1.48, 95% CI: 1.07-2.06). Among those with non-RA PAD, IT/CIT was associated with significantly better OS compared with CT (aHR = 0.77, 95% CI: 0.64-0.91; sensitivity: aHR = 0.71, 95% CI: 0.60-0.84). DISCUSSION: ICIs may be safe for older adults with PAD with respect to serious irAEs and may confer OS benefits among those with non-RA PAD. However, the less consistent results observed in patients with RA indicate the need for additional studies to more clearly define the effects of ICIs in this subgroup.
INTRODUCTION: Older adults with cancer face diverse challenges that require multidimensional care. Family caregivers, as the primary providers of care in the community, often undertake heavy responsibilities without suff...INTRODUCTION: Older adults with cancer face diverse challenges that require multidimensional care. Family caregivers, as the primary providers of care in the community, often undertake heavy responsibilities without sufficient training or support, which can negatively impact their mental health and quality of life. This study aimed to examine the effect of a family-centered empowerment model on Caring Power and life satisfaction among caregivers of older adults with cancer. MATERIALS AND METHODS: In this semi-experimental study, 80 family caregivers were conveniently selected and randomly assigned to two groups: the intervention group (receiving the family-centered empowerment program) and the control group (receiving usual education). Data were collected using standardized questionnaires prior to the intervention and six weeks after, then analyzed using appropriate statistical methods. RESULTS: In the initial analysis using the independent t-test, the family-centered empowerment intervention significantly improved caregivers' effective role play, trust, awareness, and overall caring power. However, after controlling for confounding variables through multiple linear regressions, only the reduction in uncertainty and the increase in life satisfaction were significantly attributed to the intervention, while other dimensions of caring power were more influenced by individual and social factors rather than the educational intervention. DISCUSSION: The effectiveness of the empowerment model appears limited without considering caregivers' individual, psychological, and social conditions. It is recommended that future programs incorporate psychological, financial, and cultural supports alongside education to enhance caregiving effectiveness and quality.
INTRODUCTION: Nursing home residents with cancer face particularly high needs for end-of-life care compared to those without cancer. This study aims to examine differences in characteristics, advance care planning (ACP)...INTRODUCTION: Nursing home residents with cancer face particularly high needs for end-of-life care compared to those without cancer. This study aims to examine differences in characteristics, advance care planning (ACP) consultations, and end-of-life trajectories between deceased nursing home residents with and without cancer. MATERIALS AND METHODS: We conducted a cross-sectional study in 15 ACP-approved nursing homes in Lower Saxony, Germany. Data on deceased residents were collected by nursing homes from October 2023 to September 2024, immediately following each death. Information included resident characteristics, prevalence of cancer and other comorbidities at death, ACP consultations, documented end-of-life care preferences, and end-of-life trajectories including medical treatment as well as circumstances of dying. Descriptive analyses compared residents with and without cancer, and logistic regression models were used to determine factors associated with ACP consultations. RESULTS: Data from 342 deceased residents (mean age 84.6 years; 54% female) were analyzed, including 75 (22%) with cancer. Residents with cancer had significantly shorter survival after nursing home admission (median 227 vs. 661 days; p < 0.05), were younger, and had fewer diagnoses of dementia, renal insufficiency, and stroke. ACP consultations were equally common in both groups (40% vs. 39%; p = 0.91), but residents with cancer less frequently completed ACP processes (68% vs. 85%; p = 0.04) and less frequently documented preferences (56% vs. 81%; p = 0.004). Multivariable logistic regression showed no association between cancer diagnosis and ACP consultation (OR 0.92; 95% CI 0.49-1.72). End-of-life trajectories were largely comparable between residents with and without cancer, with 52% having at least one hospitalization in the last month of life and 25% dying in hospital for both groups. DISCUSSION: Despite higher needs for end-of-life care and shorter survival, nursing home residents with cancer were not more likely to receive ACP, differentiated end-of-life treatment, or tailored care compared to those without cancer. These findings highlight a structural care gap and emphasize the urgent need to timely integrate ACP for nursing home residents with cancer.
INTRODUCTION: The aim of this study was to identify which comprehensive geriatric assessment (CGA) domains most influence geriatricians' recommendations regarding cancer treatment in older adults. MATERIALS AND METHODS:...INTRODUCTION: The aim of this study was to identify which comprehensive geriatric assessment (CGA) domains most influence geriatricians' recommendations regarding cancer treatment in older adults. MATERIALS AND METHODS: This retrospective, cross-sectional study in older adults with cancer who were referred for CGA prior to receiving proposed treatment was conducted in Gelderse Vallei Hospital, the Netherlands, between February 2019 and May 2025. CGA consisted of somatic, psychological, functional, and social domains and goals-of-care. We investigated the association between variables for these domains and recommendation for treatment modification in univariate and multivariate logistic regression. The direction of treatment modification was universally a reduction or de-intensification. Domains explicitly described in the geriatricians' documentation as influencing their treatment advice were also analysed using descriptive statistics. RESULTS: In total, 245 participants were included; median age was 80 years and 49% were female. The advice to modify cancer treatment was recommended in 59 (24.1%) participants. Variables independently associated with the recommendation to modify initial cancer treatment were: higher Charlson Comorbidity Index (per unit increase: OR 1.37, 95%-CI 1.04-1.81), low Short Physical Performance Battery (score 0-6 vs 10-12: OR 4.12 95%-CI 1.37-12.38), low grip strength (percentile 0th-24th vs ≥75th: OR 8.33 95%-CI 1.75-39.54) and low Mini Nutritional Assessment (score ≤ 7 vs 12 to 14: OR 5.45 95%-CI 1.59-18.76). Domains mentioned as influential in geriatricians' recommendations were functional (13.9%), goals-of-care (13.5%), and psychological (10.2%) domains. DISCUSSION: Functional and somatic factors were independently associated with recommendation to modify treatment including low mobility, malnutrition, lower grip strength, and multimorbidity. The functional domain (13.9%) was described most frequently in geriatricians' recommendations, closely followed by the goals-of-care (13.5%).
Blumberg R, Rachel NQM, Wang Y
… +11 more, Gilbride E, Mousaw K, Hayward E, Magnuson A, Lawley M, Abdallah M, DuMontier C, Rossi L, Mohile SG, Ramsdale E, Loh KP
INTRODUCTION: Comorbidity impacts breast cancer treatment decisions, toxicity and overall survival. Use of biological therapies has rapidly expanded, with multiple new agents adopted in the past 10 years, including a ran...INTRODUCTION: Comorbidity impacts breast cancer treatment decisions, toxicity and overall survival. Use of biological therapies has rapidly expanded, with multiple new agents adopted in the past 10 years, including a range of human epidermal growth factor receptor 2 (HER2) targeting agents, cyclin-dependent kinase (CDK)4/6 inhibitors, antibody-drug conjugates, and PARP inhibitors. There has been no review assessing the influence of comorbidity on rates of drug use, toxicity, or overall outcomes. This scoping review has evaluated how comorbidity affects the prescribing, toxicity, and outcomes of biologics in breast cancer. MATERIALS AND METHODS: Using the Joanna Briggs Institute methodology for scoping reviews, all original research articles published since 2000, assessing the influence of comorbidity on use, toxicity and outcomes with biologics in breast cancer, were included. RESULTS: A total of 58 studies were included. Comorbidity assessment was heterogeneous: formal comorbidity indices were used in 18/58 studies (predominantly the Charlson Comorbidity Index, used in some form in 15/58), specific conditions as a proxy for comorbidity in 30/58, symptom burden in 3/58 and other measures in 7/58. Over half of the studies (33/58) assessed trastuzumab; we excluded 29 of these as they focused on comorbidities in relation to trastuzumab-related cardiotoxicity, which has been reviewed in existing systematic reviews. A further 4 of the 33 trastuzumab studies were retained as they also discussed biologic prescribing patterns. The remaining 29 studies assessed other anti-HER2 agents (15/29), CDK4/6 inhibitors (9/29), bevacizumab (2/29), everolimus (1/29), or multiple agents (2/29). There were no studies focused on PARP inhibitors or immunotherapies. The influence of comorbidity varied depending on the comorbidity measure used, outcome assessed, and biologic agent. Increasing comorbidity showed trends towards monotherapy prescribing (4/13) and reduced biologic initiation (6/13). Findings regarding toxicity (13/58), treatment interruption/discontinuation (7/58), and survival (6/58) were mixed. DISCUSSION: Comorbidity significantly impacts biological agent use in breast cancer, with reduced prescribing observed in patients with comorbidities. Effects on survival, toxicity, and treatment discontinuation remain heterogeneous and inconclusive. Focused research examining biologic use in specific patient subgroups with comorbidities is needed. Older age and frailty should also be explored.
Aleixo G, Ani J, Ferrell WJ
… +14 more, Malik S, Peters S, Adams C, Loreg M, Eckert A, Grant D, Perloff T, Syed M, Parikh RB, Gabriel P, Hughes S, Dotan E, Sedhom R, Takvorian SU
INTRODUCTION: Developed and endorsed by the American Society for Clinical Oncology (ASCO) in 2023, the Practical Geriatric Assessment (PGA) is a pragmatic tool that identifies vulnerabilities in older adults with cancer....INTRODUCTION: Developed and endorsed by the American Society for Clinical Oncology (ASCO) in 2023, the Practical Geriatric Assessment (PGA) is a pragmatic tool that identifies vulnerabilities in older adults with cancer. Although strong evidence supports PGA to guide clinical care for older adults with cancer, PGA remains underutilized in routine practice. The Practical Geriatric Assessment (PGA) Implementation Strategies and Correlative Evaluations (PACE-70) study evaluates an electronic health record (EHR)-based implementation strategy for the PGA in community oncology settings and investigates how PGA findings, combined with body composition and step count monitoring, can predict chemotherapy-related toxicity. MATERIALS AND METHODS: PACE-70 is a Type III hybrid implementation-effectiveness study conducted across three community oncology sites within a large academic health system in Pennsylvania and New Jersey. It will enroll approximately 140 patients in the implementation cohort and up to 100 patients in the correlative cohort. Eligible participants are adults aged ≥70 years with advanced or metastatic solid tumors initiating a new line of palliative-intent systemic therapy. In the implementation cohort, patients complete the PGA via the EHR before or during their oncology visit. Identified impairments trigger an automated alert with guideline-based recommendations for clinicians. The primary outcome is the PGA completion rate; the secondary outcome is the frequency of PGA-guided clinical actions, such as chemotherapy dose modifications or supportive care referrals. A subset of patients will consent to enroll in a prospective correlative cohort to assess the associations between PGA-identified impairments, CTbased body composition, and Fitbit-derived step counts with clinical outcomes, including toxicity, hospitalizations, falls, and quality of life. Multivariable logistic regression and model selection techniques will identify predictors of these outcomes. DISCUSSION: Despite ASCO recommendations, PGA are rarely used in routine oncology practice, largely due to barriers such as time constraints and perceived lack of clinical utility. The PACE-70 study seeks to address this gap by evaluating a scalable, EHR-based implementation strategy for the PGA, and by linking PGA results with recommendations for guideline-concordant clinical actions. By embedding PGA directly into clinical workflows, PACE-70 tests a practical model for delivering efficient, evidence-based, and age-sensitive care that can be adopted across diverse oncology settings. Moreover, PACE-70 explores adjunct strategies for monitoring objective markers of frailty, including body composition analysis and step count data - which will inform future strategies to personalize cancer care for older adults with cancer.