{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:49:10Z","timestamp":1792511350424,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T00:00:00Z","timestamp":1674518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Polypharmacy is common in older adults who are starting cancer treatment and is associated with an increased risk of potentially inappropriate medications (PIMs) and potential drug\u2010drug interactions (PDIs). The authors evaluated the association of medication measures with adverse outcomes in older adults with advanced cancer who were receiving systemic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This secondary analysis from GAP 70+ Trial (ClinicalTrials.gov identifier NCT02054741; principal investigator, Supriya G. Mohile) enrolled patients aged 70 years and older with advanced cancer who planned to start a new treatment regimen (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0718). Polypharmacy was assessed before the initiation of treatment and was defined as the concurrent use of eight or more medications. PIMs were categorized using 2019 Beers Criteria and the Screening Tool of Older Persons' Prescriptions. PDIs were evaluated using Lexi\u2010Interact Online. Study outcomes were assessed within 3\u00a0months of treatment and included: (1) the number of grade \u22652 and \u22653 toxicities according to the National Cancer Institute Common Toxicity Criteria, (2) treatment\u2010related unplanned hospitalization, and (3) early treatment discontinuation. Multivariable regression models examined the association of medication measures with outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean patient age was 77\u00a0years, and 57% had lung or gastrointestinal cancers. The median number of medications was five (range, 0\u201324 medications), 28% of patients received eight or more medications, 67% received one or more PIM, and 25% had one or more major PDI. The mean number of grade \u22652 toxicities in patients with polypharmacy was 9.8 versus 7.7 in those without polypharmacy (adjusted \u03b2\u00a0=\u00a01.87; standard error, 0.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;.01). The mean number of grade \u22653 toxicities in patients with polypharmacy was 2.9 versus 2.2 in patients without polypharmacy (adjusted \u03b2\u00a0=\u00a00.59; standard error, 0.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.04). Patients with who had one or more major PDI had 59% higher odds of early treatment discontinuation (odds ratio, 1.59; 95% confidence interval, 1.03\u20132.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a cohort of older adults with advanced cancer, polypharmacy and PDIs were associated with an increased risk of adverse treatment outcomes. Providing meaningful screening and interventional tools to optimize medication use may improve treatment\u2010related outcomes in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.34642","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T10:24:30Z","timestamp":1674555870000},"page":"1096-1104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Association of polypharmacy and potential drug\u2010drug interactions with adverse treatment outcomes in older adults with advanced cancer"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2936-5794","authenticated-orcid":false,"given":"Mostafa R.","family":"Mohamed","sequence":"first","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya G.","family":"Mohile","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine M.","family":"Juba","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Wegmans School of Pharmacy  Rochester New York USA"},{"name":"Department of Pharmacy University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah Poh","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Flannery","sequence":"additional","affiliation":[{"name":"School of Nursing University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Culakova","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5348-4470","authenticated-orcid":false,"given":"Rachael G.","family":"Tylock","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-168X","authenticated-orcid":false,"given":"Erika E.","family":"Ramsdale","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010017\u20100621\u20102"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999\u2010021\u201000479\u20103"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21387"},{"key":"e_1_2_8_5_1","first-page":"32","article-title":"Polypharmacy: evaluating risks and deprescribing","volume":"100","author":"Halli\u2010Tierney AD","year":"2019","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.734045"},{"key":"e_1_2_8_7_1","volume-title":"Strategies to Reduce Polypharmacy in the Elderly","author":"Dahal R","year":"2022"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.258"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2013.827660"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2020.7628"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019\u20100406"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2014.04.002"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina56070320"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(21)01789\u2010x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu145"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3163\/1536\u20105050.103.2.016"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa213"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2016.01.012"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147\u2010012\u20100425\u20105"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glaa128"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2018.02.007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.496"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2015.05.001"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228\u2010014\u20101786\u20107"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12942"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2014.06.018"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2021.01.009"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010018\u20104281\u20103"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102021\u2010148731"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/oncolo\/oyac053"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34642","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.34642","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T14:00:22Z","timestamp":1760277622000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.34642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,24]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/cncr.34642"],"URL":"https:\/\/doi.org\/10.1002\/cncr.34642","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,24]]},"assertion":[{"value":"2022-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}