The impact of GOLD (Geriatric Oncology Liaison Development) service in oncology patients with significant co-morbidities and/or borderline performance status

90 Background: ASCO guidelines suggest patients > 65 should have a formal geriatric assessment [1]. We set up a new service in a London Cancer Centre. Cancer patients > 65 were reviewed in a one-stop GOLD clinic. Their focus was to provide a holistic approach to improve the oncology management. Nevertheless, not all cancer patients are fit to receive SACT. The aim of this study was to retrospectively review this group of patients. Methods: From October 2016 to April 2018, 596 patients were reviewed by GOLD. We analysed data for 298 (50%), including GOLD interventions and oncology management. In this cohort, 73% were between70-84 years (median 78). While most patients had SACT, 36 (12.4%) were deemed unfit by the oncology teams and had best supportive care only. These patients had a median age of 78.7 (64-93) and 20 (55.5%) were between 70-84. We also collected data on palliative care referral. Results: The main referrers were GI (10, 28%) and Urology (9, 25%). The rest included haematology (7, 19.4%), lung (5, 13.9%), gynaecology (3, 8.3%), melanoma and H&N (1, 2.8%) each. Referrals came mainly from the oncology teams (22, 61.1%). The remainder were identified from screening due to age (10, 27.8%) or following inpatient admission/Acute Oncology attendance (4, 11.1%). Co-morbidities and borderline performance status for systemic treatment were the two most common reasons for GOLD reviews (47.2% each), 8.3% involved polypharmacy and 2 (5.5%) cases involved social issues. Medication changes were advised for 52.8%. 41.6% did not have any changes to their management. One patient (2.8%) was referred to AHP and one (2.8%) to community palliative care. Fifteen (41.7%) had been referred to the Palliative Care team at the time of their review by GOLD. Conclusions: Despite multi-professional input, there are patients who remain unfit for SACT. It remains unclear whether a one-stop GOLD review added to the management of this group. Further evaluation is required to correctly identify patients who do not require multiple reviews. [1] Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology Hurria et al.