Telemedicine for Improvement of Care for Older Adults With Cancer in the Underserved Community, The GAIN-S Trial

NCT ID: NCT06022965

Last Updated: 2025-10-06

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

NA

Total Enrollment

216 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-24

Study Completion Date

2027-01-24

Brief Summary

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This clinical trial evaluates whether geriatric assessment-driven interventions with supportive care (GAIN-S) using telemedicine can be used to identify areas of vulnerability (weakness) in older adults with cancer and guide interventions to assist the patient and the healthcare team in the underserved community. The majority of patients diagnosed with cancer are over age 65 years, yet most cancer treatments are developed and tested in a younger population. Therefore, older patients with cancer are less likely to be offered standard treatments because of the concern regarding side effects. Geriatric assessment (GA) is a multi-dimensional health assessment tool combining patient reported and objective (unbiased) results. There is no standard tool that can identify which older adults will be more likely to have side effects from cancer treatment. Telemedicine is a way to provide healthcare services (including consultations, education, care management and treatment) in which the health care provider is at a distant site. The goal of this project is to use telemedicine to identify areas of vulnerability/weakness in older adults with cancer using a patient assessment, and to identify the potential referrals to a multi-specialty team based on patient assessment results. Information gathered from this study may help researchers learn whether GAIN-S can be performed using telemedicine and lead to improvement in care for older adults compared to standard of care (SOC) in the underserved community.

Detailed Description

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PRIMARY OBJECTIVES:

I. To implement Geriatric Assessment-driven interventions with supportive care (GAIN-S) through telemedicine to:

Ia. To improve communication between the primary care team (oncologist, nurses) and patients and caregivers in a remote community setting to increase prognostic discussions and goal concordant care; Ib. To improve cost-saving in older patients with cancer.

SECONDARY OBJECTIVES:

I. Determine whether GAIN-S implemented in a community setting will lead to a decrease in treatment toxicity.

II. To examine whether GAIN-S intervention will lead to improvement in hospitalizations, dose delays, dose reduction and discontinuation.

III. To compare patient satisfaction using the "Was It Worth It" (WIWI) between the 2 arms at the 3 and/or 6-month timepoint.

IV. To compare patient preferences at baseline, using the validated patient-defined treatment preference and goals measures between the 2 arms and longitudinal change, at 3 and/or 6-month timepoint.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I (GAIN-S): Patients complete the Cancer and Aging Research Group-Geriatric Assessment (CARG-GA) at baseline and 3 months and receive GA-based interventions using telemedicine over 6 months.

ARM II (SOC): Patients complete the CARG-GA at baseline and 3 months and receive SOC over 6 months.

Conditions

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Hematopoietic and Lymphoid System Neoplasm 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 (GAIN-S)

Patients complete the CARG-GA at baseline and 3 months and receive GA-based interventions using telemedicine over 6 months.

Group Type EXPERIMENTAL

Best Practice

Intervention Type OTHER

Receive SOC

Comprehensive Geriatric Assessment

Intervention Type OTHER

Complete CARG-GA

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Supportive Care

Intervention Type OTHER

Receive GA-based interventions

Telemedicine

Intervention Type OTHER

Receive GA-based interventions via telemedicine

ARM II (SOC)

Receive SOC over the first 3 months, then switch to receive GA-based interventions using telemedicine for the following 3 months.

Patients complete the CARG-GA at baseline and 3 months and receive SOC over 6 months.

Group Type ACTIVE_COMPARATOR

Best Practice

Intervention Type OTHER

Receive SOC

Comprehensive Geriatric Assessment

Intervention Type OTHER

Complete CARG-GA

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Interventions

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Best Practice

Receive SOC

Intervention Type OTHER

Comprehensive Geriatric Assessment

Complete CARG-GA

Intervention Type OTHER

Electronic Health Record Review

Ancillary studies

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Supportive Care

Receive GA-based interventions

Intervention Type OTHER

Telemedicine

Receive GA-based interventions via telemedicine

Intervention Type OTHER

Other Intervention Names

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standard of care standard therapy Supportive Therapy Symptom Management Therapy, Supportive Telehealth

Eligibility Criteria

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Inclusion Criteria

* Documented informed consent of the participant.
* Patient's physician must agree for patient participation.
* Ability to read English, Spanish, or Chinese. Other languages will be acceptable with site principal investigator (PI) agreement if surveys are available, and language does not preclude completing study procedures.
* Age: \>=65 years at the time of enrollment.
* Diagnosis of stage I-IV cancer.
* Scheduled to start a new therapy (chemotherapy, immunotherapy, or targeted therapy).

Exclusion Criteria

* Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics).
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

City of Hope Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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William Dale

Role: PRINCIPAL_INVESTIGATOR

City of Hope Medical Center

Locations

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City of Hope Medical Center

Duarte, California, United States

Site Status RECRUITING

City of Hope Antelope Valley

Lancaster, California, United States

Site Status RECRUITING

City of Hope Upland

Upland, California, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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William Dale

Role: primary

626-256-4673

William Dale

Role: primary

626-256-4673

William Dale

Role: primary

626-256-4673

Other Identifiers

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NCI-2023-05945

Identifier Type: REGISTRY

Identifier Source: secondary_id

22343

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA033572

Identifier Type: NIH

Identifier Source: secondary_id

View Link

22343

Identifier Type: -

Identifier Source: org_study_id

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