Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Physician lesson

Geriatric assessment before chemotherapy

Function, falls, cognition, nutrition, medicines and social support, and how it reduces toxicity

Updated: 28 October 20261 min read5 references

Key points

  • ASCO: geriatric assessment for all patients aged 65 and over receiving chemotherapy [1].
  • Assessment, and acting on it, reduced severe toxicity in two randomised studies [2, 3].
  • Quick tools: G8 for screening and CARG for predicting toxicity [4, 5].

What should we assess?

Minimum assessment (ASCO) [1]
DomainSimple toolAction for an abnormal finding
FunctionInstrumental activities of daily living (IADL)Physiotherapy, occupational therapy
FallsAsk about falls in the past 6 monthsBalance and home assessment
CognitionMini-CogAssess decision-making capacity, involve the family
MoodGDS or PHQTreat depression
NutritionUnintended weight lossNutritional counselling
Comorbidities and medicinesA full medicine listStop inappropriate medicines
ToxicityCARG or CRASHDose reduction, G-CSF, close follow-up

Evidence

GAP70+‎: giving the assessment results and recommendations to the oncologist reduced grade 3 to 5 toxicity from 71% to 51%, without reducing survival [2]. GAIN: multidisciplinary interventions based on the assessment reduced grade 3 or higher toxicity from 60.6% to 50.5% [3].

Tools: G8 · CARG · ECOG/Karnofsky

References

5 references
Show all referencesClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric OncologyMohile SG, Dale W, Somerfield MR, et al · J Clin Oncol · 2018;36:2326-2347
    DOIPubMed Back to text: 1 2
  2. 2
    Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised studyMohile SG, Mohamed MR, Xu H, et al · Lancet · 2021;398:1894-1904
    DOIPubMed Back to text: 1 2
  3. 3
    Geriatric Assessment-Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults With Cancer: A Randomized Clinical TrialLi D, Sun CL, Kim H, et al · JAMA Oncol · 2021;7:e214158
    DOIPubMed Back to text: 1 2
  4. 4
    Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter studyHurria A, Togawa K, Mohile SG, et al · J Clin Oncol · 2011;29:3457-65
    DOIPubMed Back to text
  5. 5
    Screening older cancer patients: first evaluation of the G-8 geriatric screening toolBellera CA, Rainfray M, Mathoulin-Pélissier S, et al · Ann Oncol · 2012;23:2166-2172
    DOIPubMed Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/learn/geriatric-oncology-assessment/

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