VA researchers offer simpler way to identify harmful meds in older cancer patients
VA Boston Healthcare System researchers validated the use of a specifically-curated tool for determining which medications may be causing harm for older patients with cancer, according to research published in the Journal of the National Comprehensive Cancer Network's September 2025 issue.
Lead author Dr. Jennifer La, of VA Boston's Cooperative Studies Program Center and Harvard Medical School, senior author Dr. Clark DuMontier, also of VA Boston and Harvard Medical School, as well as Brigham and Women’s Hospital/Dana-Farber Cancer Institute, and their team evaluated the tool, which is based on information from the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology for Older Adult Oncology, called the “Geriatric Oncology Potentially Inappropriate Medications” scale, or GO-PIMs for short, using data from the VA Cancer Registry to determine how well the GO-PIMs scale can identify high-risk medications and their association with outcomes in more than 380,000 older adults diagnosed with cancer between Jan. 1, 2000, and Dec. 31, 2022.
“This research is about making treatment safer and more tolerable — especially for older adults who are already vulnerable to adverse events,” said La. “We found that many patients are prescribed chronic and supportive care medications that may do more harm than good — especially when they’re already dealing with complex health issues. These medications, rapidly identified by the GO-PIMs scale, were linked to higher rates of frailty, hospitalizations, and even death. By identifying and reviewing these prescriptions early, we can potentially improve safety and outcomes for people undergoing cancer treatment.”
The researchers found that 38% of patients were prescribed at least one GO-PIMs, most-commonly selective serotonin reuptake inhibitors, known as SSRIs. Each additional GO-PIM was associated with a 66% increase in odds of being mildly or moderately-to-severely frail at diagnosis. The findings confirmed that the GO-PIMs tool can identify high-risk medications that may impact patients and outcomes negatively.
“We hope this research encourages oncology teams to routinely review medication lists — not just count the number of drugs, but look closely at which ones might be risky,” added DuMontier. “Tools like the GO-PIMs scale can be built into electronic health records to flag concerning prescriptions. We need to weigh the risks and benefits carefully, and when possible, consider safer alternatives or deprescribing. Finding the right balance requires individual considerations for each patient, and we hope tools like GO-PIMs and frailty assessment will help make that possible. We are currently piloting such an approach using GO-PIMs in our local clinic.”
The research is available at https://jnccn.org/view/journals/jnccn/23/9/article-p363.xml