ABSTRACT
Background: Older patients with cancer remain at high risk for negative outcomes from COVID-19 infection, particularly those who have multimorbidities and on immunosuppressive therapy. These patients have been excluded or underrepresented in pivotal COVID-19 vaccine clinical trials and there are ongoing concerns that they may not acquire the same level of protection from the available vaccines as the immunocompetent adults. Moreover, the level of protection wanes over time making them more susceptible to emerging COVID-19 novel variants of concern. Despite the implementation of global vaccination campaigns which have successfully reduced COVID-related hospitalisations and deaths in many parts of the world, there remains many unresolved issues and challenges to address as the pandemic ensues. With aging, concerns for age-related dysregulation and immune dysfunctions called immunosenescence may lead to potentially lower immunogenicity to vaccines. Despite receiving the primary vaccination, real-world evidence showed that both patients aged > 65 years and those with cancer have a higher risk of developing breakthrough COVID-19 infections and related complications. Subsequent booster doses are found to be effective at improving immune response, particularly against the novel variants, and the vulnerable population should be given the priority in booster campaigns. Method(s): Since the beginning of the pandemic in 2020, The International Society of Geriatric Oncology set up a COVID-19 Working Group comprised of multidisciplinary specialists by developing recommendations, advocacy, and action plans based on expert opinion and evidence related to older adults with cancer. Result(s): The table below summarises the updated recommendations from the SIOG COVID-19 Working Group. Conclusion(s): The SIOG COVID-19 Working Group supports ongoing public health interventions, continued mass immunisations, and booster campaigns targeting the most vulnerable members of the society, including older adults with cancer (Table Presented).
ABSTRACT
Cancer represents a typical disease of advanced age. Considering the aging of our societies we face the need to individualize treatment algorithms in this subgroup of patients. Telemedicine represents an effective modality to deliver individualized care and to minimize the amount of face-to-face contacts in vulnerable populations. Moreover, this procedure is quite useful in the continuous monitoring of patients as it facilitates a more frequent follow-up as compared with assessments which are performed exclusively during visits in out-patient clinics. Thus, a dramatic increase of telemedicine during the COVID-19 pandemic has been observed. As part of this concept, electronic patient-reported outcome measures (ePROMs) have been developed to assess remotely patients' perception and opinion. In addition biologic parameters such as physical activity, cardiac frequency, sleep, or temperature may be assessed by devices such as smart tools or other wearables. In clinical studies telehealth programs have so far been used in prevention and in proactive strength training, behavioral intervention, or symptom management in cancer survivors. Ongoing phase-III studies compare the in person care of patients with a telehealth-delivered counseling. Telemedicine certainly will remain a frequently used modality and offers a lot of opportunities to improve health care even in cancer patients at advanced age. Integration of ePROMs and biological parameters facilitates continuous monitoring. Digital solutions will facilitate individualized timely and personalized interventions and counseling programs. Challenges are the so far limited experience and data in older patients, the lack of familiarity with technology in this subgroup and the widespread access to broadband technologies. The development of structured programs that address the needs of patients and stakeholders is essential. In this presentation an overview on the actual implementation of telemedicine in geriatric oncology will be given.