Data on octogenarian patients with MM are scarce, and optimal management remains controversial. We report a retrospective cohort of unselected octogenarian patients with NDMM treated with bortezomib dexamethasone (Vd). Seventy-four patients were treated with an initial doublet therapy (Vd regimen, 2–3 cycles, induction). A dose escalation with an adjunction of melphalan or cyclophosphamide was proposed for patients who had an insufficient response after induction and who could tolerate it. In responders, the treatment was continued until progression or a plateau response for 6 months (consolidation). The overall response rate was 73%. After a median follow-up of 31.4 months, median progression-free survival (PFS) and overall survival (OS) were 13.2 and 26.9 months, respectively. PFS and OS of patients with ECOG PS < 3 (25.4 and 54.9 months, respectively) were better in comparison to PFS and OS of patients with ECOG PS ≥ 3 (9.3 and 11.3 months, respectively). Thirteen patients (17.6%) died during induction. Twelve patients (16.2%) died during consolidation. In conclusion, a conservative therapeutic strategy based on Vd resulted in a good response rate. However, the survival remains poor in the population of patients with an ECOG PS ≥ 3, mainly because of early mortality not related to progressive disease.

Introduction: We conducted a retrospective multicenter cohort study of patients receiving Immunoglobulin replacement therapy (IgRT) for secondary immune deficiency (SID) during 2012. Methods: Data were retrospectively collected from the first dose of Ig administered in 2012 to 1 year afterward in terms of the indication for IgRT, as well as efficacy and safety. Results: In total, 16 hospitals participated in the study, and 368 patients were included. Indications for IgRT were non-Hodgkin lymphoma (82 [22.3%] patients), multiple myeloma (76 [20.7%]), chronic lymphocytic leukemia (64 [17.4%]) and other (79 [21.5%]). Only 89 (24.2%) patients received IgRT according to 2011 European Medical Agency (EMA) recommendations; 196 (53.3%) received prophylactic antibiotics and 262 (76.2%) had an IgG level < 4 g/L before IgRT initiation. Conclusion: In this study, whatever the criteria, only 24.2% of patients with SID who received IgRT met EMA recommendations, which suggests a misuse of IgRT in SID.

Background Several multicenter randomized controlled trials comparing laparoscopy and conventional open surgery for colon cancer have demonstrated that laparoscopic approach achieved the same oncological results while improving significantly early postoperative outcomes. These trials included few elderly patients, with a median age not exceeding 71 years. However, colon cancer is a disease of the elderly. More than 65% of patients operated on for colon cancer belong to this age group, and this proportion may become more pronounced in the coming years. In current practice, laparoscopy is underused in this population. Methods The CELL (Colectomy for cancer in the Elderly by Laparoscopy or Laparotomy) trial is a multicenter, open-label randomized, 2-arm phase III superiority trial. Patients aged 75 years or older with uncomplicated colonic adenocarcinoma or endoscopically unresectable colonic polyp will be randomized to either colectomy by laparoscopy or laparotomy. The primary endpoint of the study is overall postoperative morbidity, defined as any complication classification occurring up to 30 days after surgery. The secondary endpoints are: 30-day and 90-day postoperative mortality, 30-day readmission rate, quality of surgical resection, health-related quality of life and evolution of geriatric assessment. A 35 to 20% overall postoperative morbidity rate reduction is expected for patients operated on by laparoscopy compared with those who underwent surgery by laparotomy. With a two-sided α risk of 5% and a power of 80% (β = 0.20), 276 patients will be required in total. Discussion To date, no dedicated randomized controlled trial has been conducted to evaluate morbidity after colon cancer surgery by laparoscopy or laparotomy in the elderly and the benefits of laparoscopy is still debated in this context. Thus, a prospective multicenter randomized trial evaluating postoperative outcomes specifically in elderly patients operated on for colon cancer by laparoscopy or laparotomy with curative intent is warranted. If significant, such a study might change the current surgical practices and allow a significant improvement in the surgical management of this population, which will be the vast majority of patients treated for colon cancer in the coming years. Trial registration ClinicalTrials.gov NCT03033719 (January 27, 2017).

Abstract Background : Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in elderly patients and R-CHOP chemotherapy is the standard treatment protocol for DLBCL. Elderly patients (often defined as 75 years of age) are treated with anticancer drugs with precaution; however, the pharmacokinetics and pharmacodynamics (PK and PD) of these agents have not been thoroughly investigated in this population. In this study we investigated the PK of cyclophosphamide (CP) and doxorubicin (DOX) in elderly patients in order to verify if there is an influence of age on the PK of these anticancer drugs. Methods: Non-Hodgkin lymphoma elderly patients were treated with a R-miniCHOP chemotherapy regimen. Dose levels were 25 mg/m², 0.7-1.4 mg/m², 750 mg/m² and 375 mg/m² for DOX, Vincristin (VCR), CP and Rituximab respectively. For PK analysis, 7 time point samples were collected over 48 h post administraion on cycle 3. CP and VIN plasma concentrations were measured using UPLC-MS/MS validated method. DOX plasma concentrations were measured using UPLC coupled with fluorescence detection validated method. PK-POP modeling has been performed with a non linear mixed effect model program (Monolix version 4.3.2). Results: 31 patients (15 males and 16 females), 75 to 96 years old, were treated with DOX and CYP. Among them, 19 patients have received VCR. A total of 134 and 120 concentrations for DOX and CP were used respectively for PK-POP modeling. A 2-compartment open model adequately described DOX concentration versus time courses. A 1-compartment open model adequately described CP concentration versus time courses. The interindividual variabilities (ISV) could be well estimated for both drugs and for all structural parameters (clearances: CL, Q, volumes of distribution: Vc, Vp) except V for CP. The population PK parameters for DOX obtained for the structural model were: CL=54.5 L/h, Q=54.7 L/h, Vc=30.6 L , Vp= 1140 L. The population PK parameters for CP were: CL=3.49 L/h, Vc=29.2 L. VCR increases DOX Vc from 30.6 L to 56.9L L/h (p =0.0012). The main covariate effects were related to gender, age, BW and to albumin. Conclusions: In this study we have estimated with very good precision PK parameters of DOX and CP in very elderly patients with DLBCL. Our data revealed the effect of gender, BW and VCR administration on DOX PK parameters. We have demonstrated the effect of increasing age on PK of CP. A PK-PD modeling will be performed in order to verify there are biological factors explaining the variation in the PK parameters of DOX and CP in elderly patients. Citation Format: Elodie BAUDRY, Anne Laure COUDREC, Pascal CHAIBI, Fanny BRET, Sara DJEBNOUN, Sophie WEILL, Samuel HUGUET, Alexandre BOYAULT, Francois LOKIEC, Keyvan REZAI. Pharmacokinetic study of RCHOP protocol in elderly patients with non-Hodgkin lymphoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5044. doi:10.1158/1538-7445.AM2017-5044

Red blood cell transfusion in elderly patients with anemia requires taking into account a hemoglobin threshold, as well as comorbidities that may be decompensated by anemia. In the absence of consensual indications for blood transfusion in the elderly population, it seems important to evaluate the practical approach of blood transfusion in geriatrics. We analyzed prescriptions of red blood cell transfusion in very old patients hospitalized in a geriatric teaching hospital.This retrospective study was based on information collected during one year in 736 red blood cell transfusion prescriptions. Hemoglobin levels, numbers of red blood cell units and clinical informations notified by prescribing physicians have been collected and analyzed.The mean hemoglobin level before red blood cell transfusion was 8.45±0.94g/dL. Two variables were significantly associated with an increase of the transfusion threshold above 9g/dL: the poor tolerance of anemia (P<10(-4)) and clinical situations at risk for poor tolerance of anemia (P=0.0076). The most frequent symptoms of poor tolerance of anemia were cardiovascular symptoms and also acute neuropsychiatric symptoms that could be considered as specific criteria for the red cell transfusion in the elderly. The mean number of red blood cell units prescribed for each transfusion was 1.88±0.55 and the only predictive factor was the hemoglobin level (P<0.001).In our geriatric practice, transfusion thresholds and target hemoglobin levels after transfusion seemed to be comparable with the thresholds recommended in the only available French guidelines edited in 2002 by the Afssaps. However, our study pointed out specific geriatric particularities in red blood cell transfusion prescriptions with the use of some tolerance criteria that seem related to non-cardiovascular comorbidities. Future prospective interventional studies could be conducted in order to evaluate the clinical relevance of these potential specific geriatric criteria in transfusion indications.

Background > Red blood cell transfusion in elderly patients with anemia requires taking into account a hemoglobin threshold, as well as comorbidities that may be decompensated by anemia. In the absence of consensual indications for blood transfusion in the elderly population, it seems important to evaluate the practical approach of blood transfusion in geriatrics. We analyzed prescriptions of red blood cell transfusion in very old patients hospitalized in a geriatric teaching hospital.Methods > This retrospective study was based on information collected during one year in 736 red blood cell transfusion prescriptions. Hemoglobin levels, numbers of red blood cell units and clinical informations notified by prescribing physicians have been collected and analyzed.Results > The mean hemoglobin level before red blood cell transfusion was 8.45 +/- 0.94 g/dL. Two variables were significantly associated with an increase of the transfusion threshold above 9 g/dL: the poor tolerance of anemia (P < 10(-4)) and clinical situations at risk for poor tolerance of anemia (P = 0.0076). The most frequent symptoms of poor tolerance of anemia were cardiovascular symptoms and also acute neuropsychiatric symptoms that could be considered as specific criteria for the red cell transfusion in the elderly. The mean number of red blood cell units prescribed for each transfusion was 1.88 +/- 0.55 and the only predictive factor was the hemoglobin level (P < 0.001).Perspectives > In our geriatric practice, transfusion thresholds and target hemoglobin levels after transfusion seemed to be comparable with the thresholds recommended in the only available French guidelines edited in 2002 by the Afssaps. However, our study pointed out specific geriatric particularities in red blood cell transfusion prescriptions with the use of some tolerance criteria that seem related to non-cardiovascular comorbidities. Future prospective interventional studies could be conducted in order to evaluate the clinical relevance of these potential specific geriatric criteria in transfusion indications.

hma.2012.0743 Auteur(s) : Bruno Cazin, Pascal Chaibi, Florence Cymbalista, Alain Delmer, Pierre Feugier, Luc Fornecker, Veronique Leblond, Vincent Levy, Anne-Sophie Michallet, Bruno Moulin, Brigitte Pegourie, Georges Sebbane, Pierre Soubeyran, Xavier Troussard1 troussard-x@chu-caen.fr, Jean-Marc Zini Pour l’intergroupe GCFLLC/MW/GOELAMS 1 Service d’hematologie, CHU Cote-de-Nacre, 14000 Caen, France Correspondance: X. Troussard La leucemie lymphoide chronique (LLC) represente en France 1 % [...]

6110 Background: Therapeutic decision remains complex when a cancer is diagnosed in elderly pts. Our aim was to evaluate the frequency of CI in this population and its impact on therapeutic decision. Methods: An oncogeriatric evaluation including Comprehensive Geriatric Assessment (CGA) is systematically performed for all elderly cancer pts referred in our unit. We reviewed data of all pts assessed by geriatric oncologist at our institution from January 2009 to June 2011. Results: 378 pts were identified, among them a CI was noted in 87. Median age was 84 years (range 71 –94), 70 % ≥ 80 years. Most of the pts (78/87) were referred at the time of diagnosis. Metastatic disease was diagnosed in 32 pts (52%) and Diffuse Large B Cell Lymphoma stage III or IV in 21 pts (81 %). In 41 pts, CI was already diagnosed: Alzheimer disease (AD) (n=38) and Vascular Dementia (n=3). CGA help to identify CI in 46 additional pts: AD (n=36); Vascular Dementia (n=2) and Mild Cognitive Impairment (n=8). 45/87 pts (52 %) were dependant for at least one activity of daily living (ADL). As a result of CGA and benefit/risk oncologic assessment, best supportive care was recommended in 12 pts. Among them, only 4 pts presented with advanced metastatic disease (main reason for palliative care). Pts in whom “best supportive care” decision (n=12) was recommended were more dependants than those who received specific anticancer therapy (n=75): dependence for at least 2 ADL: 10/12 pts (83%) versus 16/75 (21%); and presented more AD already diagnosed (11/12 versus 30/75). In the remaining 75 pts, specific cancer therapy was proposed, including chemotherapy (n=67), surgery (n=5), radiotherapy (n=3) and hormonotherapy (n=9). Treatment was initiated as recommended in all but 4 pts (best supportive care decision taken following discussion with pts and relatives). During the follow-up, only 11/75 pts needed to be placed in nursing home because of loss of autonomy. A survival ≥ 1 year was observed in 27/75 (36%) pts. An update of cognitive performance will be presented. Conclusions: Our data support that even if CI is frequent in elderly pts with malignancies, specific anticancer therapy remains feasible and should be considered in most elderly pts with CI.

e18505 Background: DLBCL occurs frequently in elderly pts and recent studies demonstrated that immunochemotherapy with R-mini-CHOP could be a safe and effective treatment for selected pts over 80 years Methods: Since 2008, R-mini-CHOP has been the treatment proposed for elderly pts with DLBCL referred to our oncogeriatric unit, irrespectively of their performance status (PS). We reviewed data of elderly pts treated for DLBCL at our institution from January 2008 to June 2011. Results: 74 pts (50 women, 24 men) were treated for DLBCL. Median age was 85 years (range 71–97), 84 % of pts ≥ 80 years and 16 % of pts ≥ 90 years. 68 pts (92%) had at least one comorbidity. Median number of daily medicines was 4 (range 0 – 12), irrespectively of treatments for DLBCL. Malnutrition was diagnosed in 49 pts. 50 pts (67,5 %) had a poor PS (> 2). Age-adjusted International Pronostic Index (aaIPI) was 0-1 in 9 pts, 2 in 28 pts and 3 in 35 pts. 61 pts were treated with mini-CHOP (cyclophosphamide: 400 mg/m2 D1; doxorubicine: 25 mg/m2 D1; vincristine: 1 mg total dose D1 and prednisolone 40 mg/m2 by oral route from D1 to D5) plus rituximab (375 mg/m2 D1) every 21 days for 6 cycles. Doxorubicine was replaced by etoposide (150 mg/m2 D1) for 5 pts because of cardiac dysfunction. 8 pts received reduced dose intensity chemotherapy ( without doxorubicine) for the 2 first cycles because of high risk toxicity. Prophylaxis of neutropenia with GCSF was systematic. Median survival was 11 months. 21 pts died during treatment, because of progressive disease (13) or treatment toxicity (6). Complete response (CR) was observed in 44 pts (59,5 %). With a median follow-up of 18 months, 11 relapses were observed. In our population study, aaIPI appears highly predictive of CR, with a CR Rate of 87,5 %, 75 % and 43% respectively for pts with aaIPI 0 - 1, 2 and 3.Hematological toxicity was the most common side effect. Grade 3–4 neutropenia was observed in 28% of the pts and grade 3–4 thrombocytopenia in 12%. 14 pts (19%) experienced at least one episode of febrile neutropenia. Conclusions: In unselected elderly pts with DLBCL, immunochemotherapy with R-mini-CHOP can be effective, but with significant toxicity, even using systematic G-CSF prophylaxis. Prognosis remains poor for pts with aaIPI 3

Anemia, the most common hematological disorder in the elderly, increases the risk of mortality and morbidity and adversely affects quality of life. However, few studies focused specifically on anemia in the elderly, especially regarding the underlying causes. The main objective of this prospective study was to evaluate the causes of anemia in non-institutionalized elderly patients. We included 190 consecutive patients ≥70 years, admitted to a geriatric short-stay unit over a 1-year period. When the hemoglobin level was <120 g/L, the following serum assays were performed routinely: iron, ferritin, transferrin saturation, folate, vitamin B12, C-reactive protein, TSH, albumin, and haptoglobin. When these tests were normal, bone marrow aspiration was performed to look for myelodysplastic syndrome. Hemoglobin was <120 g/L in 83 (43.7%) of 190 included patients. Patients with anemia had a mean hemoglobin level of 105 ± 11 g/L. The most common potential causes of anemia were inflammation, severe renal impairment, severe malnutrition, and iron deficiency; each of these causes was found in at least one-third of patients with anemia. Myelodysplastic syndrome was found in all anemic patients with a normal serum screen (12/83, 14.5%). Anemia was multifactorial in most patients: the mean number of potential causes per patient was 1.85 ± 1, and 65.4% of the patients had two to four concomitant causes. The serum screen used in our study is easy to perform in ambulatory patients and identifies potential causes of anemia for which safe and effective treatments are available. Second-line bone marrow aspiration adds to the diagnostic yield.

hma.2011.0604 Auteur(s) : Pascal Chaibi1 pascal.chaibi@cfx.aphp.fr, Gilles Albrand2, Pierre Soubeyran3 1 Unite pilote de coordination en oncogeriatrie Paris-Est 2 Unite pilote de coordination en oncogeriatrie Lyon 3 Unite pilote de coordination en oncogeriatrie Aquitaine Historique L’oncogeriatrie est un concept relativement recent, apparu a la fin des annees 1980 [1]. Elle se definit comme la prise en charge globale de la personne âgee atteinte de cancer ou d’hemopathie maligne. [...]

The incidence of breast cancer is two to three times higher in women aged ≥65 years than in the whole population, whereas their mortality rate is threefold to fourfold higher. Targeted therapies allow significantly longer disease-free survival times. Nevertheless, in an elderly population, these treatments need to be prescribed with caution. This paper reviews the treatments of breast cancer in the elderly, and the issues of targeted therapies and their toxicities. Patients with human epidermal growth factor receptor (HER)-2(+) breast cancer benefit from trastuzumab; although cardiotoxic effects are observed in <5% of patients when given alone, they affect ~25% of patients when combined with anthracyclines. Bevacizumab leads to a longer progression-free survival time and lower risk for progression in patients with metastatic breast cancer when added to paclitaxel or docetaxel. Although generally well tolerated, it is associated with a higher risk for arterial thromboembolism and hypertension. Lapatinib is approved for the treatment of advanced or metastatic breast cancer in patients not responding to trastuzumab, combined with capecitabine chemotherapy. The most frequent side effects concern the gastrointestinal system and dermatologic symptoms. The life expectancy of breast cancer patients should be taken into account to determine the appropriateness of treatments. The quality of life of elderly cancer patients must be assessed with an appropriate tool. Older patients exhibit greater vulnerability, suggesting identification and exclusion of patients at high cardiac risk. Future recommendations for the treatment of elderly women with breast cancer should include a multidisciplinary approach and a global geriatric assessment before treatment with anti-HER-2 therapy or bevacizumab.

hma.2011.0603 Auteur(s) : Pascal Chaibi1,2 pascal.chaibi@cfx.aphp.fr, Nelly Koenig1, Amale Chebib1,2, Francois Piette1 1 Service de medecine interne et geriatrie, Hopital Charles-Foix, Ivry-sur-Seine 2 Unite pilote de coordination en onco-geriatrie Paris-Est En 2011, la question de la prise en charge des patients âges atteints d’hemopathies malignes apparait tout a fait d’actualite au vu de l’epidemiologie, de la demographie et des progres therapeutiques recents. Sur [...]

Abstract Abstract 2786 Background: LEN is currently the reference treatment of low/int 1 (lower) risk MDS with del 5q, yielding RBC transfusion independence (TI) in two thirds of the cases, with a median RBC-TI duration of 2.2 years. (MDS 003 trial, List, NEJM, 2006). In case of primary or secondary failure of LEN, however combined analysis of MDS 003 and MDS 004 trial showed prognosis to be unfavorable and treatment approaches uncertain. We report results of treatment with AZA in 13 lower risk MDS with del 5q with primary or secondary failure of LEN. Methods: The 13 cases were treated between November 2005 and June 2011 in 10 centers of the Groupe Francophone des Myelodysplasies (GFM). At onset of LEN, median age was 71 years, M/F 0.43, 7 patients (pts) had RAEB 1 and 6 RA, 11 had isolated del 5q and 2 had 1 additional chromosomal abnormality. IPSS was low in 6 and int 1 in 7 patients. The LEN dose was 5mg/d, 10mg/d 3 weeks/4weeks, 10mg/d in 8, 3 and 2 patients, respectively. 11 (85%) patients had achieved RBC-TI, for a median duration of 26.3m (range 5.8–57.3)(secondary failures), while 2 patients had not achieved RBC-TI (primary failures). At onset of AZA, 11 patients had progressed with a change in WHO category (RA to RAEB1, or RAEB 1 to RAEB2) in 8 patients, and/or acquisition of additional chromosomal abnormalities in 9 patients, 5 eventually having complex karyotype, of whom 2 had chromosome 17 abnormality leading to TP53 gene deletion (TP53 mutation analysis is in progress); IPSS was low (n=0), int 1 (n= 3), int 2 (n=2), high (n=8). Prior to onset of AZA, attempts had been made to increase the LEN dose from 5 to 10 mg/d in 2 patients, without success. Results: AZA was administered at the FDA/EMEA approved schedule (75mg/m2/dx7) in 12 pts, and reduced (5 day schedule) in 1 pt. The median number of cycles administered was 6 (range 1–23). Five patients (46%) achieved a response according to IWG 2006 criteria, including CR, PR, HI in 1, 0 and 4 pts respectively. All 5 responders achieved RBC –TI. 4 patients received less than 4 cycles of AZA: 2 stopped AZA after 1 cycle for hematological toxicity, 1 stopped after 3 cycles for progression, 1 pt died from septic shock after 3 cycles. Response duration was 2.9+, 4.4+, 6.2+, 13.8, and 24.6 months, respectively. No responder was allografted, but the age of responders was 68, 70, 78, 78 and 86 years, respectively. Median survival from onset of AZA was 8.8 m (range 0.8–24.9). The 5 responders were still alive 3+, 4.4+, 6.2+, 13.9+ and 24.8+ m after onset of AZA, while median survival in non-responders was 8.7 months. Among the 5 patients who responded to AZA, 4 had at onset of AZA a high IPSS, 3 had complex karyotype and 2 one additional chromosomal abn, while 4/5 had previously achieved RBC-TI with LEN (with a median duration of 26.1 months). Neither of the 2 patients with TP53 deletion responded to AZA. Finally, among the 2 primary failures to Lenalidomide, one achieved HI with AZA (of 4.4+ months duration) and the other died within 2 months. Conclusion: In this relatively small series almost 40% of the patients with lower risk MDS and del 5q who progressed under LEN could be salvaged by AZA, and might expect survival prolongation. The appearance of novel chromosomal abnormalities or complex karyotype at progression did not predict poor response to AZA, while we are currently analyzing the prognostic value of TP 53 mutations, which occur frequently at th at disease stage (Jadersten, JCO 2011), on response to AZA. Disclosures: Fenaux: Celgene: Honoraria, Research Funding.

In Europe, 60% at all cancers and 75% of all deaths from cancer occur in patients older than 65 years.The incidence of many cancers (prostate, colorectal, and hematological) either increases with age or remains high (breast and lungs).The two principal characteristics of cancer in the elderly are late diagnosis and comorbidity that requires specific geriatric assessment and cooperation between the oncologist and the geriatrician.Academic and pharmaceutical industry research must focus on the specificities of cancers in the elderly and of response to treatment according to functional abilities and comorbidity. Equal access to high quality medical core and procedures must be ensured, regardless of age; this is not currently the case everywhere.

We report two cases of myelodysplastic syndrome (MDS) with del(5q) isolated cytogenetic abnormality in elderly patients: AREB-1 in Patient 1, "5q syndrome" in Patient 2. A first line of treatment including hematopoietic growth factors (darbepoetin alone or associated with G-CSF) failed after several months and a treatment with lenalidomide was initiated in both cases. The treatment was poorly tolerated (myelosuppression) in Patient 1 without an improvement of the quality of life; a progression of the disease was observed with an increase of the bone marrow blastosis and a new acquired karyotypic abnormality (t13;17), leading to the prescription of 5-azacytidine. Patient 2 had a good response to lenalidomide for several months with an increase in the haemoglobin level and a transfusion independence. The patient's prognosis suddenly worsened with the occurrence of a blood blastosis (10%): 5-azacytidine was thus initiated. These two case reports illustrate the recent advances in the management of patients with MDS with del(5q), including the use of lenalidomide.

Elderly patients represent a heterogeneous population in which decisions on cancer treatment are often difficult. The present study aims to report a 2-year period of the activity of geriatric assessment consultations and the impact on treatment decisions. Since January 2007, we have systematically carried out geriatric consultations, using well-known international scales, for elderly patients in whom treatment decisions appear complex to oncologists. From January 2007 to November 2008, 161 patients (57 men, 104 women; median age 82.4 years, range 73-97) were seen at geriatric consultations. Most of the patients (134/161) were undergoing first-line treatment and cancer was metastatic in 86 patients (53%). Geriatric assessment found severe comorbidities (grade 3 or 4 in CIRS-G scale) in 75 patients, dependence for at least one activity of daily living (ADL) in 52 patients, cognitive impairment in 42 patients, malnutrition in 104 patients (65%) and depression in 39 patients. According to the oncologists' prior decisions, there were no changes in treatment decisions in only 29 patients. Cancer treatment was changed in 79 patients (49%), including delayed therapy in 5 patients, less intensive therapy in 29 patients and more intensive therapy in 45 patients. Patients for whom the final decision was delayed or who underwent less intensive therapy had significantly more frequent severe comorbidities (23/34, p<0.01) and dependence for at least one ADL (19/34, p<0.01). In this study, we have found that comprehensive geriatric evaluation did significantly influence treatment decisions in 82% of our older cancer patients.