Geriatric Evaluation and Management With Survivorship Health Education for Older Survivors of Cancer, GEM-S Trial

NCT ID: NCT05006482

Last Updated: 2026-01-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

668 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-21

Study Completion Date

2027-09-17

Brief Summary

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This phase III trial compares the effect of geriatric evaluation and management with survivorship health education (GEM-S) to usual care on patient-reported physical function in older survivors of cancer. Survivorship care for older adults of cancer usually consists of getting advice from their doctor. This advice may include how to do their daily activities, so they are less tired or how to manage multiple diseases, or long-term side effects from treatment. GEM-S may help improve the physical ability to perform activities of daily living, mental well-being, and memory in older survivors of cancer after chemotherapy. This study may help doctors learn if including GEM-S in their practices improves physical, mental and memory functions in their patients. The study may also help to understand how such care affects cancer patients and their caregivers' quality of life.

Detailed Description

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PRIMARY OBJECTIVE:

I. To assess the efficacy of GEM-S for improving patient-reported physical function (Functional Assessment of Chronic Illness-Fatigue Physical Well-Being Subscale \[FACIT-PWB\]) in older cancer survivors at 6 months. (Survivor Aim)

SECONDARY OBJECTIVE:

I. To assess the efficacy of GEM-S for improving patient-reported cognitive function (Functional Assessment of Cancer Therapy \[FACT\]-cognitive function \[Cog\]) in older cancer survivors at 6 months.

TERTIARY OBJECTIVES:

I. To assess the preliminary efficacy of GEM-S for improving:

Ia. Objective physical function (6-minute walk test) in older cancer survivors at 6 months; Ib. Objective cognitive function (Objective Cognitive Tests-Trail Making Part A/B \[TMT A/B\] and Controlled Oral Word Association \[COWA\] \[i.e., FAS Test\]) in older cancer survivors at 6 months.

EXPLORATORY HEALTH CARE OBJECTIVES:

I. To explore the preliminary efficacy of GEM-S for improving:

Ia. Survivor satisfaction with care (Health Care Climate Questionnaire \[HCCQ\] and communication about aging) at 6 months; Ib. Care coordination (# of contacts for co-management) up to 6 months; Ic. Survivor completion of referral appointments (# completed/# referrals) up to 6 months.

EXPLORATORY CAREGIVER OBJECTIVES:

I. To explore the preliminary efficacy of GEM-S for improving:

Ia. Caregiver distress (Distress Thermometer) at 6 months; Ib. Caregiver quality of life (Caregiver Quality of Life Index) at 6 months; Ic. Satisfaction with care (Health Care Climate Questionnaire \[HCCQ\] and communication about aging) at 6 months.

OUTLINE: Practice sites are randomized to 1 of 2 arms. Participants are assigned to arms based on practice site.

ARM I: Survivors and caregivers receive routine survivorship follow-up care at their doctor's office for 3 visits over 6 months on study.

ARM II: Survivors and caregivers participate in GEMS consultation over 1 hour that includes discussion of results and recommendations from geriatric assessment. Both survivors and caregivers also participate in survivorship health education (SHE) sessions over 75 minutes twice weekly for 4 weeks. Survivors and caregivers also participate in Exercise for Cancer Patients (EXCAP) program, which includes daily walking and resistance exercises.

After completion of study intervention, participants are followed up at 6 months.

Conditions

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Lymphoma Malignant Solid Neoplasm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Arm I (usual care)

Survivors and caregivers receive routine survivorship follow-up care at their doctor's office for 3 visits over 6 months on study.

Group Type ACTIVE_COMPARATOR

Best Practice

Intervention Type OTHER

Receive usual follow-up survivorship care

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm II (GEMS intervention)

Survivors and caregivers participate in GEMS consultation over 1 hour that includes discussion of results and recommendations from geriatric assessment. Both survivors and caregivers also participate in SHE sessions over 75 minutes twice weekly for 4 weeks. Survivors and caregivers also participate in EXCAP program, which includes daily walking and resistance exercises.

Group Type EXPERIMENTAL

Comprehensive Geriatric Assessment

Intervention Type OTHER

Complete geriatric assessment

Educational Intervention

Intervention Type OTHER

Participate in survivorship health education sessions

Exercise Intervention

Intervention Type OTHER

Participate in SHE-EXCAP program

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Tailored Intervention

Intervention Type PROCEDURE

Participate in GEM consultation

Interventions

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Best Practice

Receive usual follow-up survivorship care

Intervention Type OTHER

Comprehensive Geriatric Assessment

Complete geriatric assessment

Intervention Type OTHER

Educational Intervention

Participate in survivorship health education sessions

Intervention Type OTHER

Exercise Intervention

Participate in SHE-EXCAP program

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Tailored Intervention

Participate in GEM consultation

Intervention Type PROCEDURE

Other Intervention Names

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standard of care standard therapy Education for Intervention Intervention by Education Intervention through Education Intervention, Educational

Eligibility Criteria

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Inclusion Criteria

* PRACTICE CRITERIA: Participating practice clusters will be required to identify one (or more) oncologist and/or advanced practice practitioner (APPs; i.e., nurse practitioners, or physician assistants) as part of study eligibility. If another clinician is interested in participating, please contact University of Rochester Cancer Center (URCC) National Cancer Institute Community Oncology Research Program (NCORP) Research Base (RB) for approval

* Oncologists/APPs/other clinicians must be licensed to practice
* Oncologists/APPs/other clinicians must not have a plan to leave or retire from the NCORP practice within one year of enrolling into the study
* PRACTICE CRITERIA: Support/buy-in from oncology physicians and/or APPs and/or other clinicians who are willing to participate in training and study procedures and enroll cancer survivors
* ENTRY CRITERIA FOR ONCOLOGY PHYSICIANS/APPS/OTHER CLINICIANS: Oncology physicians/APPs/other clinicians must work at a participating site with no plans to leave that practice or retire within one year of enrollment into the study. We do not require that any or all oncology physicians and/or APPs at a practice setting agree to participate. Only one clinician is required for the practice cluster to be eligible. If another clinician (other than oncology physician or APP) is interested in participating, please contact URCC NCORP RB for approval
* CANCER SURVIVORS: 65 years or older
* CANCER SURVIVORS: Have completed or will have completed curative-intent treatment (e.g., surgery, chemotherapy, chemotherapy with radiation) for any solid tumor or lymphoma malignancy in last 6 months. If the survivor is receiving curative-intent chemotherapy, run-in study procedures can occur during the last 6 weeks of chemotherapy.

* Cancer survivors who will receive or are receiving other treatments (e.g., hormonal treatment, monoclonal antibodies, immunotherapy, radiation) are eligible
* For patients receiving neoadjuvant chemotherapy for curative intent, the run-in and baseline procedures can occur before or after surgery. Patients should be enrolled within 6 months from the end of surgery
* CANCER SURVIVORS: Be willing and able to come in for study visits or willing to undergo informed consent and assessments remotely via tele-health visits
* CANCER SURVIVORS: Be willing and able to provide informed consent and must sign consent in-person or remotely if it is not convenient or feasible to provide informed consent in-person
* CANCER SURVIVORS: Speak and understand English and/or Spanish. Spanish-speaking cancer survivors are eligible as long as there are appropriate resources in place for completion of study procedures at the practice site. Registration for Spanish-speaking cancer survivors must be approved by the URCC NCORP Research Base after a phone call to determine the feasibility for the practice to enroll a Spanish-speaking participant
* CAREGIVERS: 18 years or older
* CAREGIVERS: Selected by the cancer survivor when asked if there is a "family member, partner, friend or caregiver (age 18 years or older) with whom you discuss or who can be helpful in health-related matters." A caregiver need not be someone who lives with the cancer survivor or provides direct hands-on care
* CAREGIVERS: Speak and understand English and/or Spanish. Spanish-speaking caregivers are eligible as long as there are appropriate resources in place for completion of study procedures. Registration for Spanish-speaking caregivers must be approved by the URCC NCORP Research Base after a phone call to determine the feasibility for the practice to enroll a Spanish-speaking participant

Exclusion Criteria

* CANCER SURVIVORS: Have a condition that precludes their ability to participate in informed consent or procedures (e.g., dementia)
* CAREGIVERS: Caregivers unable to understand the informed consent form or study procedures due to cognitive, health, or sensory impairment will be excluded

* Capacity to conduct informed consent procedures and study procedures will be determined by the coordinators in collaboration with the cancer survivors' oncologists. These procedures are similar to that of URCC 13070, which enrolled caregivers of older patients with advanced cancer
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Rochester

OTHER

Sponsor Role lead

Responsible Party

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Supriya Mohile

URCC Study Chair

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Supriya G Mohile

Role: PRINCIPAL_INVESTIGATOR

University of Rochester NCORP Research Base

Locations

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Lewis and Faye Manderson Cancer Center

Tuscaloosa, Alabama, United States

Site Status RECRUITING

Kaiser Permanente-Fremont

Fremont, California, United States

Site Status RECRUITING

Kaiser Permanente-San Francisco

San Francisco, California, United States

Site Status RECRUITING

Helen F Graham Cancer Center

Newark, Delaware, United States

Site Status RECRUITING

Medical Oncology Hematology Consultants PA

Newark, Delaware, United States

Site Status RECRUITING

Hawaii Cancer Care Inc - Waterfront Plaza

Honolulu, Hawaii, United States

Site Status RECRUITING

Straub Clinic and Hospital

Honolulu, Hawaii, United States

Site Status RECRUITING

Kapiolani Medical Center for Women and Children

Honolulu, Hawaii, United States

Site Status RECRUITING

Tripler Army Medical Center

Honolulu, Hawaii, United States

Site Status RECRUITING

Hawaii Cancer Care - Westridge

‘Aiea, Hawaii, United States

Site Status RECRUITING

Pali Momi Medical Center

‘Aiea, Hawaii, United States

Site Status RECRUITING

OSF Saint Anthony's Health Center

Alton, Illinois, United States

Site Status RECRUITING

Fairview Southdale Hospital

Edina, Minnesota, United States

Site Status RECRUITING

Hennepin County Medical Center

Minneapolis, Minnesota, United States

Site Status RECRUITING

Monticello Cancer Center

Monticello, Minnesota, United States

Site Status RECRUITING

Park Nicollet Clinic - Saint Louis Park

Saint Louis Park, Minnesota, United States

Site Status RECRUITING

Regions Hospital

Saint Paul, Minnesota, United States

Site Status RECRUITING

Lakeview Hospital

Stillwater, Minnesota, United States

Site Status RECRUITING

Rice Memorial Hospital

Willmar, Minnesota, United States

Site Status RECRUITING

Minnesota Oncology Hematology PA-Woodbury

Woodbury, Minnesota, United States

Site Status RECRUITING

Lake Regional Hospital

Osage Beach, Missouri, United States

Site Status RECRUITING

Noyes Memorial Hospital/Myers Cancer Center

Dansville, New York, United States

Site Status RECRUITING

Northwell Health/Center for Advanced Medicine

Lake Success, New York, United States

Site Status RECRUITING

Highland Hospital

Rochester, New York, United States

Site Status RECRUITING

Pluta Cancer Center

Rochester, New York, United States

Site Status RECRUITING

University of Rochester

Rochester, New York, United States

Site Status RECRUITING

Wilmot Cancer Institute at Webster

Webster, New York, United States

Site Status RECRUITING

Novant Health Breast Surgery - Greensboro

Greensboro, North Carolina, United States

Site Status RECRUITING

Novant Health Cancer Institute - Kernersville

Kernersville, North Carolina, United States

Site Status RECRUITING

Novant Health Cancer Institute - Mount Airy

Mount Airy, North Carolina, United States

Site Status RECRUITING

Novant Health Cancer Institute - Statesville

Stateville, North Carolina, United States

Site Status RECRUITING

Novant Health Cancer Institute - Thomasville

Thomasville, North Carolina, United States

Site Status RECRUITING

Novant Health Forsyth Medical Center

Winston-Salem, North Carolina, United States

Site Status RECRUITING

South Central Medical and Resource Center

Lindsay, Oklahoma, United States

Site Status RECRUITING

Geisinger Medical Center

Danville, Pennsylvania, United States

Site Status RECRUITING

Geisinger Cancer Center Dickson City

Dickson City, Pennsylvania, United States

Site Status RECRUITING

Community Medical Center

Scranton, Pennsylvania, United States

Site Status RECRUITING

Geisinger Wyoming Valley/Henry Cancer Center

Wilkes-Barre, Pennsylvania, United States

Site Status RECRUITING

Chesapeake Regional Medical Center

Chesapeake, Virginia, United States

Site Status RECRUITING

ThedaCare Regional Cancer Center

Appleton, Wisconsin, United States

Site Status RECRUITING

HSHS Sacred Heart Hospital

Eau Claire, Wisconsin, United States

Site Status SUSPENDED

Saint Vincent Hospital Cancer Center Green Bay

Green Bay, Wisconsin, United States

Site Status RECRUITING

Saint Vincent Hospital Cancer Center at Saint Mary's

Green Bay, Wisconsin, United States

Site Status RECRUITING

Marshfield Medical Center-River Region at Stevens Point

Stevens Point, Wisconsin, United States

Site Status RECRUITING

Marshfield Medical Center - Weston

Weston, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Site Public Contact

Role: primary

800-338-2948

Site Public Contact

Role: primary

877-642-4691

Site Public Contact

Role: primary

877-642-4691

Site Public Contact

Role: primary

302-623-4450

Site Public Contact

Role: primary

302-623-4450

Site Public Contact

Role: primary

808-524-6115

Site Public Contact

Role: primary

808-522-4333

Site Public Contact

Role: primary

808-983-6090

Site Public Contact

Role: primary

808-433-6336

Site Public Contact

Role: primary

808-539-2273

Site Public Contact

Role: primary

808-486-6000

Site Public Contact

Role: primary

618-463-5623

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

952-993-1517

Site Public Contact

Role: primary

573-302-2768

Site Public Contact

Role: primary

Site Public Contact

Role: primary

516-734-8896

Site Public Contact

Role: primary

585-341-8113

Site Public Contact

Role: primary

888-823-5923

Site Public Contact

Role: primary

585-275-5830

Site Public Contact

Role: primary

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

336-718-8335

Site Public Contact

Role: primary

405-756-1414

Site Public Contact

Role: primary

570-271-5251

Site Public Contact

Role: primary

877-204-6081

Site Public Contact

Role: primary

570-703-4768

Site Public Contact

Role: primary

570-271-5251

Site Public Contact

Role: primary

Site Public Contact

Role: primary

920-364-3604

Site Public Contact

Role: primary

920-433-8889

Site Public Contact

Role: primary

920-433-8889

Site Public Contact

Role: primary

800-782-8581

Site Public Contact

Role: primary

800-782-8581

References

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Yilmaz S, Janelsins MC, Flannery M, Culakova E, Wells M, Lin PJ, Loh KP, Epstein R, Kamen C, Kleckner AS, Norton SA, Plumb S, Alberti S, Doyle K, Porto M, Weber M, Dukelow N, Magnuson A, Kehoe LA, Nightingale G, Jensen-Battaglia M, Mustian KM, Mohile SG. Protocol paper: Multi-site, cluster-randomized clinical trial for optimizing functional outcomes of older cancer survivors after chemotherapy. J Geriatr Oncol. 2022 Jul;13(6):892-903. doi: 10.1016/j.jgo.2022.03.001. Epub 2022 Mar 12.

Reference Type DERIVED
PMID: 35292232 (View on PubMed)

Other Identifiers

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NCI-2021-01760

Identifier Type: REGISTRY

Identifier Source: secondary_id

URCC-19178

Identifier Type: OTHER

Identifier Source: secondary_id

URCC-19178

Identifier Type: OTHER

Identifier Source: secondary_id

URCC-19178

Identifier Type: OTHER

Identifier Source: secondary_id

R01CA249467

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1CA189961

Identifier Type: NIH

Identifier Source: secondary_id

View Link

URCC-19178

Identifier Type: -

Identifier Source: org_study_id

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