Geriatric oncology: from research to clinical practice

Prof Dr Hans Wildiers, medical oncologist at the University Hospitals Leuven reported from the annual meeting of the SIOG in Ghent to mark both the organisation’s 25th anniversary and the maturation of geriatric oncology as a scientific discipline. This year’s theme, “from research to clinical practice,” reflects the transition from accumulating evidence to addressing the challenges of real-world implementation. Over the past quarter century, SIOG has generated substantial data demonstrating that geriatric assessment and related interventions improve clinical outcomes for older adults with cancer. However, widespread integration of this knowledge into routine oncology care remains limited.

The opening session focused on implementation strategies and presented diverse care models from Canada, India, Europe and other regions. Although healthcare systems differ markedly, common principles emerged, including the need for systematic assessment of comorbidities, functional status, psychosocial needs, and patient preferences. Models vary in structure and resource intensity. Some centres have established dedicated geriatric oncology units where comprehensive assessments are performed, but these programs cannot accommodate all older patients and require additional hospital visits. Alternative models rely on brief screening instruments administered in oncology settings, followed by referral to geriatric services only when indicated. These approaches appear feasible and scalable, particularly in resource-limited contexts.

Future strategies may adopt hybrid structures integrating digital solutions. Several presentations described electronic self-assessment tools completed by patients before oncology consultations, with results automatically incorporated into the electronic health record. Such systems enable clinicians to identify vulnerabilities proactively and facilitate interdisciplinary management. They also support more informed deliberations within multidisciplinary tumour boards, which currently focus predominantly on tumour biology and treatment modalities, often without incorporating geriatric parameters or patient-defined goals of care. Evidence indicates that incorporating these factors can meaningfully alter treatment decisions, leading either to intensification or de-escalation depending on patient fitness, burden of comorbidity, or care priorities.

Despite growing recognition of the need for tailored approaches, most cancer centres worldwide still lack structured geriatric oncology pathways. The meeting underscored that no single implementation model is universally applicable; successful integration must align with institutional workflows, available expertise and local patient populations. Collaborative learning across centers is therefore essential. The primary objective remains constant: improving the quality, safety and person-centeredness of cancer care for older adults. The SIOG meeting represents an important step toward translating established research evidence into sustainable clinical practice.