OPTImisation of cancer treatment in AGEd persons : integration of geriatric assessment and aging biomarker analysis in elderly clinical cancer trials

Treating older patients with (breast) cancer is a major challenge. On the one hand, older persons are more vulnerable to side effects of therapy, which may severely impact on quality of life. Thus, overtreatment should be avoided, but on the other hand, undertreatment (which is common in elderly) can lead to worse survival. There is a delicate balance between benefits of therapy and risk of (sometimes life threatening) toxicity. There is an urgent need for robust markers that reflect the body’s biological age and reserves, and that may aid in outlining optimal individual treatment regimens. This project is aimed at the identification of such biomarkers. In the framework of several institutional and international studies and biobanking projects in older cancer patients, we will evaluate the predictive value of a broad panel of candidate blood aging biomarkers for survival and treatment tolerance. Potential biomarkers that will be investigated cover diverse molecular aspects of the aging process, such as telomere biology, oxidative stress, age-related increase in chronic inflammation status, age-related gene expression, DNA methylation and microRNAs. In particular, we will also focus on the impact of age on the immune system, which plays a crucial role in tumor development. This project will improve our understanding of the complex interplay between cancer and aging, and will eventually contribute to better tailored elderly cancer care.