The oncological multidimensional prognostic index is a promising decision-making tool: A real-world analysis in older patients with metastatic colorectal cancer.

BACKGROUND: Approximately 50% of colorectal cancers occur in older patients. International societies recommend geriatric tools to optimise treatment of older patients. Comprehensive Geriatric Assessment (CGA) is a multidimensional assessment used to classify patients as fit, vulnerable, or frail. The CGA-based oncological multidimensional prognostic index (onco-MPI) also classifies patients as high-, intermediate-, or low-risk based on tumour characteristics. We investigated the role of CGA and onco-MPI in older patients with metastatic colorectal cancer (mCRC) in a real-world setting. METHODS: Data for consecutive mCRC patients aged ≥70 years were retrieved from a prospectively maintained database from 2010 to 2020. We analyzed patients' and tumours' characteristics, and the CGA domains. Onco-MPI was calculated by a validated algorithm derived from CGA domains. Pearson's test was used to verify whether onco-MPI scores and chemotherapy administration were correlated. RESULTS: The study included 488 mCRC patients with a mean age of 76.1 years. According to CGA, 52% of patients were fit, 28% vulnerable, and 20% frail. According to onco-MPI, 9% were low, 54% intermediate, and 37% high-risk. The median OS was 22.7 months. The following factors improved OS: 0-1 ECOG PS, low onco-MPI, fit based on CGA, chemotherapy administration, and doublet regimen. Chemotherapy administration significantly correlated with onco-MPI scores, leading to a survival gain regardless of the risk subgroups. First-line regimen had no impact on survival across the CGA and onco-MPI categories. CONCLUSION: CGA and onco-MPI scores confirmed their prognostic impact in older mCRC patients and may aid in decision-making and subgroup stratification in dedicated trials.

Regulation During the Second Year: Executive Function and Emotion Regulation Links to Joint Attention, Temperament, and Social Vulnerability in a Latin American Sample.

Although a growing body of work has established developing regulatory abilities during the second year of life, more work is needed to better understand factors that influence this emerging control. The purpose of the present study was to examine regulation capacities in executive functions (i.e., EF or cognitive control) and emotion regulation (i.e., ER or control focused on modulating negative and sustaining positive emotions) in a Latin American sample, with a focus on how joint attention, social vulnerability, and temperament contribute to performance. Sixty Latin American dyads of mothers and children aged 18 to 24 months completed several EF tasks, a Still-Face Paradigm (SFP) to examine ER (Weinberg et al., 2008), and the Early Social Communication Scale to measure joint attention (Mundy et al., 2003). Parents completed the Early Childhood Behavior Questionnaire Very Short Form to measure temperament (ECBQ-VS, Putnam et al., 2010) and the Social Economic Level Scale (SES) from INDEC (2000). Results revealed the typical responses expected for toddlers of this age in these EF tasks and in the SFP. Also, we found associations between EF and ER and between non-verbal communication related to monitoring infants' attention to objects (i.e., responding to joint attention) and initiation of pointing (e.g., pointing and showing of an object while the child alternates his gaze to an adult) with EF. Regarding social factors, family differences and type of housing contribute to regulation. For temperament, effortful control was associated with both regulatory capacities. Finally, only age predicted EF. These results suggest that many patterns regarding the development of these abilities are duplicated in the first months of life in a Latin American sample while further highlighting the importance of considering how the environment and the individual characteristics of infants may associate to these regulatory abilities, which is particularly relevant to developing public policies to promote their optimal development.