A Study Comparing Geriatric Co-Management With Geriatric Guided Supportive Care in Older Patients Receiving Chemoradiation Therapy for Their Head and Neck Cancer
Pilot Randomized Clinical Trial of Geriatric Comanagement or Geriatric Guided Supportive Care for Older Patients With Head and Neck Cancer Receiving Radiation and Chemotherapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Nancy Lee, MD
- Phone Number: 212-639-3341
- Email: leen2@mskcc.org
Study Contact Backup
- Name: Yingzhi Wu, NP
- Phone Number: 917-902-2972
- Email: wuy2@mskcc.org
Study Locations
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New Jersey
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Basking Ridge, New Jersey, United States, 07920
- Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities)
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Middletown, New Jersey, United States, 07748
- Memorial Sloan Kettering Monmouth (Limited protocol activities)
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Montvale, New Jersey, United States, 07645
- Memorial Sloan Kettering Bergen (Limited Protocol Activities)
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New York
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Commack, New York, United States, 11725
- Memorial Sloan Kettering Suffolk- Commack (Limited Protocol Activities)
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center (All Protocol Activities)
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Uniondale, New York, United States, 11553
- Memorial Sloan Kettering Nassau (Limited protocol activities)
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 65
- Pathologically (histologically or cytologically) diagnosis of head and neck cancer of oral cavity, oropharynx, larynx, or hypopharynx
- Patient will receive a 6 to 7 week course of intensity modulated radiation therapy and concurrent chemotherapy either in definitive or post-operative setting
- Able to read and understand English
- Able to provide informed consent
Exclusion Criteria:
- Patients who have previously consulted with or are followed by a geriatrician
- Inability to use telemedicine if unable to present to clinic visits in person
- Inability to complete the eRFA (patient is unable to comprehend or answer questions included on the eRFA)
- Treatment with proton therapy
- Patients on therapeutic clinical trials of experimental therapies or those not receiving standard of care
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: geriatric co-management
Geriatric co-management involves a consultation with a geriatrician prior to initiating head and neck radiation and chemotherapy.
Consultation with geriatricians can occur in-person or remotely via telemedicine.
During this visit, the geriatrician will review the results of the eRFA and create a plan to manage geriatric deficits.
Geriatric co-management involves optimization of comorbid conditions, management of polypharmacy, and supportive care referrals to address geriatric deficits.
Geriatricians also work in conjunction with the treating oncologists to ensure patients have appropriate pain management and bowel regimens.
Additional follow up visits after the initial consultation are at the discretion of the geriatrician may vary between patients depending on the clinical need.
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Geriatric co-management involves a consultation with a geriatrician prior to initiating head and neck radiation and chemotherapy.
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Experimental: geriatric guided supportive care
Geriatric guided supportive care will be carried out by oncologists.
After the patient completes the eRFA, an automated report is generated that identifies the patient's geriatric deficits.
The automated report also includes suggested interventions for each deficit (e.g, referral to physical therapy.
For instance, automated suggestions for a patient with a history of falls include consultation with physical therapy, neurologic evaluation, a home safety evaluation, or use of supportive devices.
Automated recommendations for patient with high level of distress or depression include referral to psychiatry or social work, involvement in a cancer support group, or additional time spent addressing questions and fears.
The oncology team will review the automated report from the eRFA and create an intervention plan prior to initiation of head and neck radiation and chemotherapy.
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Geriatric guided supportive care will be carried out by oncologists.
After the patient completes the eRFA, an automated report is generated that identifies the patient's geriatric deficits.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
proportion of patients with hospital admission (geriatric co-management arm)
Time Frame: 2 years
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The proportion of patients hospitalized during the course of chemoradiation either at MSKCC or an outside hospital will be assessed for each arm.
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2 years
|
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proportion of patients with hospital admission (geriatric guided supportive care arm)
Time Frame: 2 years
|
The proportion of patients hospitalized during the course of chemoradiation either at MSKCC or an outside hospital will be assessed for each arm.
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2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Nancy Lee, MD, Memorial Sloan Kettering Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 22-016
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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