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The 2017 edition of the SIOG Annual Conference took place in Warsaw, Poland from November 9-11. We would like to thank all participants, faculty members and industry partners for their participation which contributed to the huge success of our conference.

The SIOG 2017 Annual Conference in numbers

  • 368 delegates from 41 countries
  • 26 scientific sessions with a total of 143 talks
  • 67 faculty members from 22 countries
  • 185 abstract submissions
    • 169 accepted abstracts of which 23 were withdrawn
    • 29 oral presentations and 116 posters presented at SIOG 2017
    • 16 rejected abstracts
  • 1 industry sponsored satellite session
  • 2 sessions supported by an unrestricted educational grant
  • 525 tweets from 120 people, 114'124 reach* and 533'680 impressions** mentioning #SIOG17 and #SIOG2017.

* Reach = the number of unique users who have seen posts containing the hashtag, keyword, url and/or @mention.
** Impressions : number of times that users have seen posts containing your hashtag, keyword, url and/or @mention. A single user can deliver multiple impressions.


SIOG 2017 Awards

The SIOG 2017 Paul Calabresi award was given to Arti Hurria (US). Read More
The SIOG 2017 National Representative of the year was given to Theodora Karnakis (BR). Read More
Lodovico Balducci (US) received a SIOG Lifetime achievement Award. Read More
The 2017 BJ Kennedy award for best poster was given to Domenico La Carpia (IT) - cognitive decline and functional status in elderly cancer survivors from non hodgkin lymphoma PDF iconSIOG poster -_p043 -_d.la_carpia.pdf
The SIOG 2017 Nursing & Allied Health investigator award was given to Ramona Moor (BE) - Impact of a specific multidisciplinary geriatric oncology clinical pathway on the number and types of implemented geriatric interventions Read More
The SIOG 2017 Young investigator award was given to Melisa Wong (US) - Characteristics associated with physical function trajectories in older adults with cancer receiving chemotherapy: a multicenter prospective cohort study Read More


SIOG 2017 Session slides

The session presentations are available for SIOG members and SIOG 2017 participants. SIOG members will be able to access them by logging in their MySIOG acccount (the presentations are located under the member news section). SIOG 2017 participants can contact the SIOG Head Office at to obtain the link for the slides.


SIOG 2017 Scientific programme

The final programme is available (pdf). PDF iconSIOG 2017 Final Programme.pdf
An erratum for the final programme is available (pdf). PDF iconSIOG 2017 erratum.pdf


SIOG 2017 Photos

Selected photos taken during the conference are available on our Dropbox.


SIOG 2017 in the media

  has conducted a series of interviews of SIOG key opinion leaders and conference speakers. You can watch the videos here.
  ecancer is the leading oncology channel committed to improving cancer communication and education with the goal of optimising patient care and outcomes.
This service has been kindly supported by an unrestricted grant from Janssen Oncology. 

  All abstracts of the 17th Annual Conference of the International Society of Geriatric Oncology were published in a supplement of the Journal of Geriatric Oncology (JGO), official journal of SIOG.
 To access the online book, simply click here


CME accreditation

The SIOG 2017 Annual Conference was granted 16 European CME credits (ECMEC®s) by the European Accreditation Council for Continuing Medical Education (EACCME®). More info

Under the auspices

Recommended by


Endorsed by


  has conducted a series of interviews of SIOG key opinion leaders and conference speakers. Stay informed about the latest in Geriatric Oncology and watch the videos below
  ecancer is the leading oncology channel committed to improving cancer communication and education with the goal of optimising patient care and outcomes.
This service has been kindly supported by an unrestricted grant from Janssen Oncology. 

Industry partners 

The International Society of Geriatric Oncology thanks all sponsors for their support towards the SIOG 2017 Annual Conference.






Industry sponsored satellite session

Saturday, November 11, 2017 | Warsaw IV&V - 10:30-11:30      

Re-evaluating dexrazoxane
Chair: Etienne Brain (FR)

10:30-10:40 Welcome and introduction - Etienne Brain (FR)
10:40-11:00 Clinical indications for dexrazoxane as a cardioprotective agent - Robin Jones (GB)
11:00-11:20 Cardioprotection in elderly patients - Steven E Lipshultz (US)
11:20-11:30 Summary and questions


Educational grants

We gratefully acknowledge the following companies for their unrestricted educational grants towards our scientific programme.

The following session has been supported by and unrestricted education grant by Sanofi Genzyme.
DAY 1 - Thursday, November 9, 2017 - Warsaw IV & V
14:45-15:45 Educational session: Update of the treatment of prostate cancer in the elderly
Chairs: Nicolas Mottet (FR) and Eleni Efstathiou (GR/US)
14:45-15:00 Urological aspects and application of SIOG guidelines - Nicolas Mottet (FR)
15:00-15:15 Consensus of the Advanced Prostate Cancer Conference 2017 (St. Gallen, CH) - Iwona Skoneczna (PL)
15:15-15:30 Presentation of the outstanding phase III trials ASCO 2017 (Latitude and Stampede) - Eleni Efstathiou (GR/US)
15:30-15:45 Case discussion - Shabbir Alibhai (CA)

The following session has been supported by and unrestricted education grant by BTG/TheraSphere and Varian Medical Systems.
DAY 2 - Friday , November 10, 2017 - Warsaw IV & V
09:30-11:00 Educational session: Liver cancer in the elderly
Chairs: Daniel Anaya (US) and Sarah Hoffe (US)
09:30-09:50 Liver cancer: a common and reversible cause of mortality in older patients - Lodovico Balducci (US)
09:50-10:10 Surgical treatment of primary and secondary liver cancer - Daniel Anaya (US)
10:10-10:30 A radiation oncology perspective - Jessica Frakes (US)
10:30-10:50 Interventional radiology and the management of liver cancer - Junsung Choi (US)
10:50-11:00 Conclusions - Sarah Hoffe (US)

CME accreditation

The SIOG 2017 Annual Conference was granted 16 European CME credits (ECMEC®s) by the European Accreditation Council for Continuing Medical Education (EACCME®).

Accreditation Statement

Accreditation by the EACCME® confers the right to place the following statement in all communication materials including the event website, the event programme and the certificate of attendance. The following statements must be used without revision:
“The SIOG 2017 Annual Conference, Warsaw, Poland, 09/11/2017-11/11/2017 has been accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 16 European CME credits (ECMEC®s). Each medical specialist should claim only those hours of credit that he/she actually spent in the educational activity.”

Through an agreement between the Union Européenne des Médecins Spécialistes and the American Medical Association, physicians may convert EACCME® credits to an equivalent number of AMA PRA
Category 1 CreditsTM. Information on the process to convert EACCME® credit to AMA credit can be found at

Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME® for ECMEC®s are deemed to be Accredited Group Learning Activities (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

EACCME® credits

Each participant can only receive the number of credits he/she is entitled to according to his/her actual participation at the event once he/she has completed the feedback form. Cf. criteria 9 and 23 of UEMS 2016.20.
09.11.2017 - 6.00
10.11.2017 - 6.00
11.11.2017 - 4.00
The EACCME® awards ECMEC®s on the basis of 1 ECMEC® for one hour of CME with a maximum of 8 ECMEC®s per day. Cf. Chapter X of UEMS 2016.20.

SIOG Warsaw 2017: Another successful annual conference

In November, participants from 41 countries enjoyed a highly-rewarding scientific programme and the hospitality of the historic Polish capital.  Delegates heard a mix of practical advice, expert reviews and updates – including from studies not yet been published – covering advances in surgery and medical and radiation oncology as they relate to older patients, as well as the expanding role of geriatric assessment in optimizing outcomes in routine clinical practice.

Older patients are the majority of patients. They are frequently frail and vulnerable. They need to be the focus of our endeavours.

In a highly informative opening session, Hans Wildiers (Leuven, Belgium) described progress with CDK 4/6 inhibitors in metastatic breast cancer. The combination of efficacy with relatively low toxicity – even in the elderly -- represents a major advance. That said, the optimal sequencing of therapy remains unclear, and women with low volume, endocrine-sensitive tumours may benefit long-term from aromatase inhibitor monotherapy. There are also encouraging data on oral chemotherapy with vinorelbine and capecitabine, another relatively well-tolerated option.

In HER2-positive MBC, the recent EORTC trial recruited only women aged 70 years and older or those with defined functional limitations or comorbidities. Patients received pertuzumab and trastuzumab with or without metronomic oral cyclophosphamide. In data previewed by Hans Wildiers, PFS was superior among women receiving the additional cyclophosphamide. This suggests that chemotherapy does confer benefit, even with dual HER2 blockade, though it can be delivered in a relatively non-toxic regimen.

Disability and self-rated health
Among recent research papers in geriatric oncology, Marije Hamaker (Utrecht, NL) noted:  

  • Patients (mean age 84) can use the sliding scale OPT tool to prioritise outcomes such as remaining alive, maintaining independence and reducing pain. This means of establishing patient preference is now being used routinely in Groningen.
  • Self-rated health predicts decline in IADL among people aged 65 and over living in the community. After 3 years, 13% of men and 8% of women had become dependent by IADL.
  • Who cares for the carer? In the UK, one in three people in their late 80s has difficulty with at least five tasks of daily living and needs help. Of almost nine million carers, 25% are aged over 65 and two-thirds themselves have a health-related condition or disability.
  • Meta-analysis shows that integrating discharge planning with informal caregivers reduces readmission rates by a quarter and reduces cost of post-discharge care.
  • Many people with poor hearing do not use a hearing aid. Systematic review shows that hearing loss is common but frequently overlooked in studies of patient/physician communication.

Ovarian cancer
Older women with ovarian cancer have a two-fold increased risk of death, and are less likely to undergo complete staging or to receive standard chemotherapy. They experience more treatment toxicity and are less likely to be enrolled in trials, William Tew (MSKCC, New York, USA) told the Warsaw conference.

Post operative complications occur in around 30% of women older than 70, and this may delay chemotherapy – which is an argument for neoadjuvant treatment. Practice at MSKCC is to give chemotherapy up-front in patients aged over 75 years and those with advanced disease. But the optimum sequencing of surgery and chemotherapy is debated.

A review (in press) of trials of the PARP inhibitor olaparib in heavily pre-treated patients will show that there is no consistent increase in adverse events with age. But dose reduction was considerably more common in women over 75, who suffer more prone fatigue and anaemia. This may suggest a lower starting dose.

Integrating GA into routine care
In a striking metaphor, geriatric assessment was described as seeing below the surface of the impairment iceberg. A major theme of the conference was the increasing integration of GA into all modalities of care.

Mike Jaklitsch (Brigham and Women’s Hospital, Harvard, US) noted the extent to which survival and morbidity following surgery are influenced by pre-operative function: depending on status, 30-day mortality ranges from 1% to 5.6%, and rate of grade 4 complications from 4% to 14%. At the Brigham and Women’s Hospital, geriatric services are now embedded in the thoracic surgery clinic: patients have a one hour interview including MMSE, ADL/IADL, and assessment of PS and polypharmacy.

Memorial Sloan Kettering (New York, US) is pioneering an electronic tool known as eRapid Fitness Assessment. The eRFA is essentially a comprehensive GA, said Armin Shahrokni, since it covers comorbidities, ADL/IADL, timed up and go, falls, weight loss, social support, emotional status, sensory deficits, mini-Cog, and polypharmacy. Remarkably, 90% of older patients (median age 80!) completed the eRFA in less than 21 minutes. It can be completed prior to the appointment or even at home (patients receive an e-mail containing a link to the tool).

GA and everyday decisions
In Groningen, patients aged 70 and over now have a nurse-led GA covering social, functional and psychological domains, along with frailty, QoL, and patient preferences – using the sliding-scale OPT tool mentioned above. Among 250 patients assessed between 2014 and 2016 (mean age 78 years), 39% gave their highest priority to prolonging life but 60% did not consider this the most important outcome; and 39% gave maintaining independence their highest preference.

A multidisciplinary onco-geriatric team shares decision making with a tumour board, said Suzanne Festen. Their deliberations changed the advice of the tumour board in 48% of cases. Hence GA can be patient-friendly, feasible, and lead to modification of treatment.

Shabbir Alibhai (Toronto, CA) had a similar message. In a prospective study at the Princess Margaret Cancer Center, a cohort of 219 patients (mean age 80 years) had a CGA. Results and recommendations were fed back to the oncologist. In 39% of 97 patients referred in the pre-treatment phase, management was changed. Most frequently this related to provision of education, management of comorbidities and management of symptoms.

Geriatric oncology pathway enhances care
Ramona Moor (Brussels, BE) described how a multidisciplinary GO pathway was prospectively assessed in 1310 old and frail cancer patients (mean age 81). Features include screening using the G8, geriatric assessment if the G8 was 14 or less, assessment of patient preferences, and a dedicated multidisciplinary meeting leading to a personalized care plan.

Geriatric problems were found in 96% of patients; the mean number of interventions recommended was 4 per patient, and the mean number implemented was 3.5. The most frequent were nutritional (in 80% of patients) and functional support (in 40%).

In the same study, each patient enrolled a caregiver (mean age 66 years). Twentysix percent reported anxiety and 19% depression; 39% had a comorbidity. Carers with anxiety tended to be younger, were taking care of patients with more GA impairments, and of patients who were more distressed.

Trust is hard-won
Andreas Charalambous (Univ of Technology, Cyprus) described a model linking trust in nurses to quality of nursing care, health status, and patients’ perception that nurses are caring for them as an individual. Data from 590 patients drawn from hospitals in Finland, Greece, Cyprus and Sweden show that having high levels of trust required the presence of all the model’s elements, ie health status, individualized care, and nursing care quality.

The model highlights the complexity of caring for cancer patients, and nowhere is this more evident than in palliation. The Dignity Care Intervention is a tool for community nurses to identify individual patients’ concerns through use of reflective questions. Patients see it as empowering and nurses see it as helpful, said Ulrika Östlund (Linnaeus Univ, Sweden). A Swedish version of the Intervention has now been developed.

The times they are a-changing
We owe our vulnerable patients new clinical trial strategies, argued Stuart Lichtman (MSKCC, New York, US).

Drugs change, patients change, times change…  It is time for clinical trial eligibility to change too. We no longer need cut-and-paste protocols.

Eligibility criteria for trials of chemotherapy have probably always been too strict. With targeted agents and immunotherapies, which do not create the same concerns about safety, this is now certainly true. Hence the October 2017 paper in JCO arguing for modernizing enrollment by relaxing exclusion criteria.

This should bring trial participants closer to those in routine practice. It will also aid in finding the smaller subsets of patients whose tumours have the molecular characteristics that match the activity of targeted agents.

We should also argue for the inclusion of patients with lower than standard creatinine clearance since this can be taken into account by prospectively defined dose adjustments -- as was demonstrated in the the Alliance study of adjuvant CMF or AC vs. capecitabine in older breast cancer patients with a creatinine clearance of less than thirty.

Martine Extermann (Tampa, Florida, US) continued the theme of clinical trial relevance, suggesting that a trial should be considered applicable to our practice if more than 60% of our everyday patients would be eligible for inclusion. To evaluate the validity of a study, read the methods section!

As well as looking at the eligibility criteria, look at the proportion completing treatment, route of drug metabolism, and drug interactions. And understand the implication of comorbidities for drug toxicity, such as the way diabetes increases taxane neuropathy.

Modelling survival in AML
Martine Extermann also provided the conference with some breaking news in haematology.

Over the past 25 years, 5-year survival has improved markedly for AML patients under 50 but has not improved for patients aged over 65: it still 3%! While different biology and absence of BMT are part of the story, suboptimal therapy may contribute.

Along with colleagues at the Moffitt, she obtained data on 13,000 patients (median age 75) involved in 68 studies and compared outcome with high-dose chemotherapy (HDC), hypomethylating agents (HMA), or low-dose chemotherapy and BSC. The model took account of age, cytogenetics, PS, and comorbidities.  Outcome was the odds ratio for being alive at 1 year.

HDC and HMA seemed similarly effective: the survival ORs for patients who were ECOG 0-1, Charlson 2 and good/intermediate cytogenetic risk were 0.59 for HDC and 0.57 for HMAs. With low-dose chemotherapy the OR was only 0.46; and for BSC 0.29. Can we expect more studies of HMAs?

Immune-related toxicities no barrier
Ishwaria Subbiah (MDA, Houston, US), a finalist in the SIOG Young Investigator Award, compared toxicity in MDA patients aged 65 and over with that in younger patients taking part in phase I trials of immunotherapy agents.  

The rate of any toxicty in older patients was significantly higher: 53% vs 39%; as was Grade 3-4 toxicity, at 19% vs 11%. But differences were in large part due to more frequent grade 1-2 toxicities that are familiar – such as fatigue, fever and anorexia – rather than the more alarming immune-related acute toxicities such as hypothyroidism, hepatitis, pancreatitis, and pneumonitis. Rates of these events were all 2% or less in patients aged 65 and over, as they were in younger patients.

In a nuanced review of immune-oncology (IO), Alastair Greystoke (Newcastle-upon-Tyne, GB) considered the agents now in use. Toxicities such as the endocrinopathies and pneumonitis tend to be indiosyncratic, may be delayed, may require long-term immunosuppression and can take a long time to resolve.

In theory, older patients might respond less well due to immunosenescence and “inflammaging”, with higher levels of pro-inflammatory cytokines, while an increase in auto-antibodies might exacerbate toxicities.

In practice, though, the evidence is that – even if patients over 75 years may respond less -- those aged 65-75 do as well as those who are younger. Patients with a poor PS due to comorbidities seem to do well with IOs, while those with poor PS due to tumour burden do not.

Immunotherapy for stage IV NSCLC is the “new kid on the block” with five positive phase III trials, four of them in second line, Lore Decoster (Brussels, Belgium) reported. Responses can be durable; toxicity is less than with chemotherapy; and quality of life is better. So this treatment is a good option for the elderly -- although Lore Decoster agreed that there is a question over its use in patients aged 75 and older and in those who are PS 2.

The abscopal phenomenon – the ability of radiotherapy to trigger a systemic anti-tumour effect – is an exciting area of research: irradiation of one metastasis causes others to disappear. There seems to be priming of immune cells against tumour antigens, said Charles Kelly (Newcastle-upon-Tyne, GB).

Previously described in immunogenic cancers, interest in the abscopal effect has been given impetus by the success of immune-oncology agents, and all solid tumours are being revisited with a view to exploiting the potential of RT to release immunogenic factors.

Playing football with prostate cancer 
The 50% of men diagnosed with prostate cancer who have ADT risk decreased BMD and lean body mass. Exercise may counter these effects, and it looks as if one way of doing this is to organize a football team.

Jacob Uth (Copenhangen, DK) described an RCT in which men on ADT were randomised to football training or no intervention. Among the footballers, lean body mass at week 12 had increased, while it fell in controls. The between-group difference of 0.7 kg was statistically significant.  Benefit was also seen in muscle strength. On the downside, the footballers experienced two fractures of the fibula and three muscle or tendon injuries.

To screen or not to screen
Worthwhile screening requires a disease whose natural history can be altered by intervention and a positive effect on the balance of risks and benefits for the population screened, argued Shabbir Alibhai (Toronto, CA).

Age affects the latter since competing causes of mortality become more evident (and hence years of life gained by screening become less); and the harms of the process itself (such as bowel perforation with colonoscopy) may become greater.

We need to know how long patients must live before they reap any benefit from screening. With breast cancer, that is likely to be 5-7 years. For many cancers it is ten. Hence we need to estimate an individual’s life expectancy.

An upper age limit may be rational, but there are barriers to implementing such a policy. One is that people have a favorable opinion of screening and it takes time to explain why this may not be the case for an individual. It is more tactful to say “this test will not help you live longer” than “you might not live long enough to benefit from this test”!

Falls: management, prevention
The SIOG Nursing and Allied Health Group has reviewed the literature and existing guidelines. As outlined by Schroder Sattar (University of Toronto, CA) the group suggests the following:

For outpatients: ask about falls and difficulty with walking and balance at every clinical encounter; assess patients who report a fall/difficulty with walking or balance; obtain detailed history of falls and the circumstances. Address orthostatic hypotension, footwear and foot problems; offer an exercise programme incorporating strength and balance training.

For inpatients, address medication, mental state, and environment; practise least restraint; assess risk factors daily; and during hourly rounds assess the 5Ps -- pain, personal needs, position, placement, prevention.

Adherence to oral therapy  
Adherence may be the single most important modifiable factor affecting treatment outcome, suggested Tanya Wildes (St Louis, US). Around 20% of patients adhere poorly to oral therapy. But there is heterogeneity in the way adherence is measured and no gold standard.

SIOG recommendations are now published: Mislang AR, Wildes TM, Kanesvaran R et al.  Adherence to oral cancer therapy in older adults: The International Society of Geriatric Oncology (SIOG) taskforce recommendations. Cancer Treat Rev. 2017;57:58-66.

Quality of life   
A SIOG Task Force is considering the issue. Among the take-home messages listed by Fábio Gomes (PT/ Manchester, GB) were:

  • QoL considerations are essential in management and should be a goal of care
  • age itself does not decrease QoL
  • QoL assessment can be challenging in some elderly patients
  • QoL tools should be used together with a CGA, and QoL should be measured at baseline and at regular intervals
  • the care of elderly patients should be provided by a MDT
  • QoL assessment may identify unmeet needs
  • it should not be perceived as time consuming; QoL assessment helps tailor the best strategy and may actually save time and resources in the long-term.

Nutrition and outcome in GI cancers 
According to Federico Bozzetti (Milan, IT), older patients have a high prevalence of malnutrition (rates range from 20-60%). This translates into worse chemotherapy toxicity and a poorer outcome (including some evidence of shorter survival) when compared with well-nourished patients. Sarcopenia also increases chemotherapy toxicity and shortens survival.

The effects of nutritional interventions parallel those observed in younger patients. Simple nutritional counselling is generally not effective in improving QoL or survival. EPA-enriched oral supplements are moderately effective and should be considered in the early phases of therapy. There is evidence of increased lean body mass and one recent study shows improved survival. Prolonged supplemental parenteral nutrition provides passive continuous support and is associated with the best results.