One thing that we’ve seen, and I’ve reviewed all the posters and the presentations so far, is that there’s a general trend over the last few years for real data on the studies. The quality of the posters and the presentations has increased; people are really making a great effort to do clinical trials in older patients and, again, present their data. The data includes a lot of patients, reasonable numbers, reasonable endpoints and is making valid conclusions about the studies. It has contributed to the field itself and, of course, to the quality of the meeting.
The other good thing is that this year’s SIOG meeting has the largest attendance ever. We have over 500 registrants, we’ve never had that number before, and that bodes well for the society and for next year’s meeting. So so far it’s been very good, it’s been well organised and the responses so far have been very positive.
Tell us about some of the guidelines being published.
We’ve had the latest number is 36 guidelines published, nine this year. They are making a lot of incremental changes to improve quality of life and other aspects of treatment. We’ve spent many years doing predictive models of geriatric assessment, predicting toxicity, predicting decline, and what this phase of geriatric oncology is doing is incorporating these predictive models into studies and by doing that it further refines the model and enhances outcomes. That’s reflected in the talks and the poster presentations. A lot of times these changes are not huge leaps but when you look back over the last decade or so you can clearly see these incremental changes year after year. Part of that is the fact that we just entered this new era of implementation of the results that we had from previous years.
What do you think is next for SIOG and geriatric care?
It changes because a number of things change, the drugs change. We spent decades worrying about chemotherapy side effects and we’ve really entered strongly, we’ve talked about it’s going to happen but it really is happening, an era of immunotherapy, targeted therapy, genomic based treatments. So the future is where the therapy leads us. If you have drugs with a higher therapeutic index where the concern about toxicity is less then you evaluate the patient in a different kind of way. If you’re not worried as much about toxicity or at least you feel the toxicity is manageable then the way you make a decision changes. So the future of geriatric oncology from a decision-making point of view will be dictated to a large extent by what therapeutic modalities we have.
Obviously the predictions of an aging population are true and so people who are interested in geriatric oncology have a lot of work ahead of them and there will be a lot, a lot of patients to take care of. There will be new avenues of approach and in an aging population and hopefully with less comorbidity things like surgery will have a different approach. Surgical care will be improved because of that, maybe less surgery in some circumstances. Radiation therapy may change, we see that now with more tumour specific radiation therapy or other modalities yet to be determined. So it will go where the therapeutics take us.