Chile now has its first expert consensus on oncogeriatric assessment

Until now, Chile had no guideline adapted to the local reality for assessing older people with cancer. A group of geriatricians and oncologists —among them Dr. Gonzalo Navarrete and Dr. Gabriel Martínez, members of the Oncoger team— published in the Journal of Geriatric Oncology the first national expert consensus on oncogeriatric assessment. The open-access work was led by Dr. Rocío Quilodrán (FALP) together with Dr. Isidora Jiménez (National Institute of Geriatrics) and Evangelina Röling (FALP and San Sebastián University).

Why it matters

An estimated 60% of cancer patients are over 65, a group that is especially heterogeneous and at greater risk of adverse reactions to treatment. In Chile, where cancer is the leading cause of death, the risk of developing the disease in people over 75 is estimated at 19.1%. Evidence shows that comprehensive geriatric assessment reduces severe toxicity from cancer treatments, but the lack of a local guideline had kept care fragmented and highly variable between centres.

How it was built

The team first carried out a systematic review (protocol registered in the Open Science Framework, Cochrane and PRISMA methodology) that identified 805 publications and selected four clinical practice guidelines: ASCO 2018 and 2023, NCCN 2024 and the Japanese geriatric oncology guideline. Based on their recommendations, a panel of 32 Chilean geriatricians working in oncogeriatrics voted in two Delphi rounds following the standard ESMO procedure. In the first round, consensus was reached on 12 of 16 recommendations; the remaining four were revised and approved in the second. None fell below 75% agreement.

The 16 recommendations

They all apply to people aged 65 or over with cancer. We group them by domain; in parentheses, the panel's agreement in the first round.

Main conclusions

The authors argue that the consensus is a significant advance for the care of older people with cancer in Chile and Latin America: its standardised application can help reduce treatment toxicity, improve clinical outcomes and quality of life, and sets a precedent for developing guidelines in other areas of oncology, such as surgery and hemato-oncology. They also propose it as a reference for other countries in the region facing similar challenges of population ageing, high cancer burden and inequality in access to care.

Among the limitations, the article acknowledges the scarcity of local evidence —most of the available guidelines were built with studies that do not include Latin American populations— and warns that implementing these recommendations may require changes in teams' routines, professional training and specific resources.

For Oncoger, this consensus is the clinical basis on which PROTEGER is built: the scales the panel recommends —G8, SPPB, Barthel, Lawton-Brody, MMSE, GDS-5, CARG, MAI, ePrognosis— are the same ones that feed the comprehensive assessment the platform integrates with oncological data to support the systemic-therapy decision.