Evidence map›Paper›PMID 41123568›Full record

ArticleCancer2025

Decision regret in older adults with advanced cancer receiving systemic therapy: Associations with patient-reported and clinician-rated tolerability metrics.

Marie A Flannery, Zhihong Zhang, Eva Culakova, Kah Poh Loh, Beverly Canin, Rachael G Tylock, Fiona A Stauffer, Mostafa Mohamed, Hongying Sun, Supriya Mohile

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02054741 (A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02054741 nacompletednot on this map

A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer: Reducing Toxicity in Older Adults

TypeinterventionalSponsorSupriya MohileRan2014 to 2021Enrolled733ConditionsAdult Solid Neoplasm, Toxicity, LymphomaArmsComprehensive Geriatric Assessment, Quality-of-Life Assessment, Survey Administration
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Marie A FlannerySchool of Nursing, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0000-0003-2957-8482
Zhihong ZhangSchool of Nursing, University of Rochester Medical Center, Rochester, New York, USA.
Eva CulakovaUniversity of Rochester Medical Center alumni, Rochester, New York, USA.
Kah Poh LohDepartment of Medicine, Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Beverly CaninPatient Advocate and Board Member, University of Rochester Medical Center and NIH Tolerability Consortium, Rochester, New York, USA.
Rachael G TylockDepartment of Medicine, Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Fiona A StaufferDepartment of Medicine, Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0009-0009-5171-2968
Mostafa MohamedPublic Health Sciences, Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0000-0003-2936-5794
Hongying SunDepartment of Surgery, University of Rochester Medical Center, Rochester, New York, USA.ORCID https://orcid.org/0000-0003-3144-3544
Supriya MohileDepartment of Medicine, Division of Hematology/Oncology, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.

Funding

URCC NCORP Research BaseUG1CA189961 · NCI · UNIVERSITY OF ROCHESTER · PI Michelle C Janelsins, KAREN M. MUSTIAN · 2014 to 2026
$67.7M
University of Rochester Wilmot Cancer Institute Support GrantP30CA272302 · NCI · UNIVERSITY OF ROCHESTER · PI BRIAN MARPLES · 2025 to 2026
$6.4M
Understanding Treatment Tolerability in Older Patients with CancerU01CA233167 · NCI · UNIVERSITY OF ROCHESTER · PI MOHILE, SUPRIYA G. · 2018 to 2023
$3.5M
Reducing Chemotherapy Toxicity in Older AdultsR01CA177592 · NCI · UNIVERSITY OF ROCHESTER · PI MOHILE, SUPRIYA G. · 2013 to 2018
$3.0M
A Patient-Oriented Research Program in Geriatric OncologyK24AG056589 · NIA · UNIVERSITY OF ROCHESTER · PI Supriya G. Mohile · 2018 to 2026
$1.5M
A novel mobile health exercise intervention for older patients with myeloid neoplasmsR00CA237744 · NCI · UNIVERSITY OF ROCHESTER · PI LOH, KAH POH · 2021 to 2023
$747k
Geriatric Oncology Research to Improve Clinical CareU13AG038151 · NIA · BECKMAN RESEARCH INSTITUTE/CITY OF HOPE · PI HURRIA, ARTI · 2010 to 2014
$228k
National Cancer Center R01CA177592National Cancer Center U01CA233167National Cancer Center UG1 189961NCI NIH HHS P30 CA272302NCI NIH HHS R00 CA237744NCI NIH HHS R01 CA177592NCI NIH HHS U01 CA233167NCI NIH HHS UG1 CA189961NIA NIH HHS K24 AG056589NIA NIH HHS U13 AG038151NIH HHS K24 AG056589NIH HHS R00CA237744
6 · The paper itself

Abstract

backgroundDecision regret (DR) (distress or remorse after a treatment decision) has received limited examination in older adults with advanced cancer. The authors hypothesized that DR would change over time and be associated with worse patient-reported outcomes (PRO) and clinician-rated tolerability metrics over 6 months.

methodsAdults aged 70+ with advanced cancer planning to receive systemic treatment were recruited from a national trial (GAP70+, NCT02054741). DR level (none (0), mild [1-25], and moderate/severe [>25]) and PROs (symptoms, functional status, and satisfaction with treatment) were assessed at 4-6 weeks, 3 months, and 6 months after treatment initiation and compared with ANOVA. Associations between clinician-rated grade >3 toxicities, and treatment-related hospitalizations and DR were examined with longitudinal linear mixed modeling.

resultsData from 623 patients (M = 77 years, 43% female, mixed diagnoses) who completed the DR scale at least once were analyzed. At 4-6 weeks, mean DR was 17.1 (SD = 15.7), with 50% reporting mild DR and 21% moderate/severe DR. Patients experiencing higher DR reported significantly higher concurrent symptom severity, lower functional scores, and lower treatment satisfaction (all p < .05). At 6 months, mean DR was 3.9 points higher (95% confidence interval [CI], 1.1-6.7, p = .006) in patients with any grade >3 toxicities and 6.8 points higher (95% CI, 3.4-10.2, p < .001) in patients with treatment-related hospitalization.

conclusionsDR changes over time and is associated with worse PROs and clinician-rated toxicity. Clinicians can discuss DR and poor tolerability in conversations about high-risk cancer treatment with older adults who have advanced cancer. CLINICAL TRIALS REGISTRATION: NCT02054741.

Indexed as

Decision MakingEmotionsNeoplasmsAgedAged, 80 and overFemaleHumansMaleMulticenter Studies as TopicPatient Reported Outcome MeasuresRandomized Controlled Trials as Topicadvanced cancerdecision regretolder adultpatient‐reported outcomestreatment tolerability

Identifiers

PMID41123568
PMCPMC12542926

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.