AsiaPacific Geriatric Oncology Society (AGOS; virtual tumour board no 9) real world consensus for management of endometrial cancer with multiple co-morbidities and polypharmacy in the older patient

Abstract

The AsiaPacific Geriatric Oncology Society (AGOS) conducts a monthly virtual tumour board. One of the cases discussed was a 70-year-old female with Stage IIIA endometrial cancer, multiple co-morbidities and polypharmacy. A group of experts discussed the challenges in the real world with specific reference to improving Timed Up and Go (TUG) score, managing the effect of co-morbidities, preventing risk due to drug-drug interactions and evaluating the risk of delaying anti-cancer therapy in an attempt to improve patients’ condition. He real world expert consensus is outlined here. It would take about 12 weeks to improve TUG by 3-5 seconds. Atrial fibrillation (AF), diabetes mellitus type 2, hypertension, and chronic gastritis/GERD stood out as the most important comorbidities that would increase the risk by 1.5 to 3 times for the patient. Important alternative drugs should be used in place of Amiodarone, Metformin combinations and Denosumab to reduce potential drug-drug interactions. There would be a 5 to 15 % risk of cancer progression while trying to improve the TUG score. This could translate into a 15 to 25% relative reduction in overall survival. Best-case, worst-case visuals can be used while counselling patients.