SOHO 2023 | Defining elderly patients in the context of DLBCL treatment
Pallawi Torka, MD, Memorial Sloan Kettering Cancer Center, New York City, NY, discusses the definition of elderly patients in the context of diffuse large B-cell lymphoma (DLBCL) treatment. Dr Torka comments on the use of age cut-offs to determine eligibility for DLBCL treatment in clinical trials, before highlighting the need to group older patients according to biological age instead. It is thought that fit older patients could be eligible for the same treatment as younger adult patients. This interview took place at the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO 2023) held in Houston, TX.
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Transcript (edited for clarity)
This is not as easy as it seems, because there are different age cutoffs that have been used in different trials. Initially, aged more than 60 was what was used in the IPI score and other scoring systems. For most transplant studies, aged more than 65 has been the cutoff. But more recently, I think most experts will agree that aged more than 70 is what we traditionally consider the age cutoff for DLBCL in older adults...
This is not as easy as it seems, because there are different age cutoffs that have been used in different trials. Initially, aged more than 60 was what was used in the IPI score and other scoring systems. For most transplant studies, aged more than 65 has been the cutoff. But more recently, I think most experts will agree that aged more than 70 is what we traditionally consider the age cutoff for DLBCL in older adults. But it’s not really about chronological age. I think we should have more stress on the biological age. So it is important to subject anybody who is over the age of 60 or 65, and we can talk based on logistics, what might be the best cutoff. But these patients need to be subjected to a geriatric assessment or any frailty index and then classify them into fit, unfit and frail. And technically, patients who are unfit and frail need something different. But most fit, older adults should still be considered young, older adults and get whatever their younger counterparts are eligible for.
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Disclosures
Consultancy fees from Genentech, Genmab, Seagen, ADC therapeutics, TG therapeutics, Lilly USA.
