Harvey Cohen

Overview:

Dr. Cohen's research program includes clinical research relating to aspects of the pathways to functional decline with aging, geriatric assessment, and cancer in the elderly.

Pathways to functional decline are being explored through the NIA funded Claude Pepper Older Americans Independence Center, and includes studies of the contributions of age related physiologic change, in particular changes in inflammatory parameters, comorbid diseases and conditions, environment, genetics, and the interactionas among them. Data are derived from several current studies as well as previously collected data sets from the Established Populations for Epidemiologic Studies of the Elderly (EPESE), National Long Term Care Survey, and the Chinese Longevity Study (with Dr. Zeng Yi). Previous work has demonstrated the important contributions of age related inflammation and coagulation activation to functional status.

Geriatric assessment approaches have been studied in a number of randomized and controlled studies and work is now concentrating on the application of Comprehensive Geriatric Assessment tools to the evaluation and treatment of elderly patients with cancer. This is an extension and continuation of a long standing interest in geriatric oncology. Previous studies have elucidated age-related patterns of disease presentation, treatment approaches, clinical trials, survivorship, quality of life, impact of comrobidities and functional outcomes. Dr. Cohen is co-chair of the Cancer in the Elderly Committee of Cancer and Acute Luekemia Group B (CALGB). A number of active studies and ongoing data bases aree being utilized to address these questions.

Positions:

Professor of Medicine

Medicine, Geriatrics
School of Medicine

Walter Kempner Professor of Medicine, in the School of Medicine

Medicine, Geriatrics
School of Medicine

Director, Center for the Study of Aging & Human Development

Center for the Study of Aging and Human Development
School of Medicine

Faculty Research Scholar of DuPRI's Center for Population Health & Aging

Center for Population Health & Aging
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1965

State University of New York at Brooklyn

Grants:

Quantifying the genomic consequences of chronic social stress for accelerated aging

Administered By
Institutes and Provost's Academic Units
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

IPA-Rick Sloane

Administered By
Center for the Study of Aging and Human Development
Role
Principal Investigator
Start Date
End Date

Mentoring Intervention Development in Fall and Fracture Prevention

Administered By
Medicine, Geriatrics
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

PACTTE-Partnership for Anemia: Clinical and Translational Trials in the Elderly

Administered By
Duke Clinical Research Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Cognitive Changes and Brain Connectivity in Age-Related Macular Degeneration

Administered By
Center for the Study of Aging and Human Development
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Publications:

Clinical prognostic model for older patients with advanced non-small cell lung cancer.

BACKGROUND: Older patients with non-small cell lung cancer (NSCLC) are often not prescribed standard therapy. It is important to know which older patients would be candidates for aggressive therapy based on their prognosis, and to develop a model that can help determine prognosis. METHODS: Data on older patients (≥70 years) enrolled on 38 NCI cooperative group trials of advanced NSCLC from 1991 to 2011 were analyzed. Multivariable Cox PH model was built with a stepwise selection. We derived a prognostic score using the estimated Cox PH regression coefficient. We then calculated the area under receiver operating characteristic (ROC) curve of survival in the testing set. RESULTS: The final analysis included 1467 patients, who were randomly divided into a training (n = 963) and a testing set (n = 504). The prognostic risk score was calculated as: 3 (if male) + 3 (if PS = 1) + 8 (if PS = 2) + 11 (if initial stage = IV) + 4 (if weight loss). Patients were classified into two prognostic groups: good (0-8) and poor (≥9). The median survival in the two groups in the testing set were 13.15 (95% CI, 10.82-15.91) and 8.52 months (95% CI, 7.5-9.63), respectively. The model had area under the 1-year and 2-year ROCs (0.6 and 0.65, respectively) that were higher than existing models. CONCLUSIONS: Male gender, poor performance status, distant metastases and recent weight loss predict for poor overall survival (OS) in older patients with advanced NSCLC. This study proposes a simple prognostic model for older adults with advanced NSCLC.
Authors
Ganti, AK; Wang, X; Stinchcombe, TE; Wang, Y; Bradley, J; Cohen, HJ; Kelly, K; Paulus, R; Ramalingam, SS; Vokes, EE; Pang, H
MLA Citation
Ganti, Apar Kishor, et al. “Clinical prognostic model for older patients with advanced non-small cell lung cancer..” J Geriatr Oncol, vol. 10, no. 4, July 2019, pp. 555–59. Pubmed, doi:10.1016/j.jgo.2019.02.007.
URI
https://scholars.duke.edu/individual/pub1370226
PMID
30797707
Source
pubmed
Published In
J Geriatr Oncol
Volume
10
Published Date
Start Page
555
End Page
559
DOI
10.1016/j.jgo.2019.02.007

Do older patients with non-small cell lung cancer also benefit from first-line platinum-based doublet chemotherapy? Observations from a pooled analysis of 730 prospectively-treated patients (Alliance Study A151622).

OBJECTIVE: This study sought to define the role of first-line platinum-based doublet chemotherapy in older patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: We analyzed three first-line NSCLC trials: CALGB 9730, CALGB 30203, and CALGB 30801, which tested carboplatin and paclitaxel; carboplatin and gemcitabine; and carboplatin with either pemetrexed or gemcitabine, respectively. Overall survival was the primary endpoint. Age-based comparisons with a cutpoint of 65 years were performed with Cox proportional hazards models with adjustments for sex, tumor histology, cancer stage, chemotherapy, and smoking history and after stratifying by performance score. Secondary endpoints were grade 3-5 adverse events, chemotherapy cycles completed, and whether toxicity prompted chemotherapy discontinuation. RESULTS: 730 patients were included; 337 (46%) were 65+ years of age. No statistically significant difference in survival was observed for older (≥65) versus younger patients (HR = 1.096; 95% CI = (0.94, 1.28); p = 0.25). A trend emerged with increased odds of a grade 3-5 adverse event for patients ≥65 years versus <65 years (OR = 1.52; 95% CI = (0.99, 2.31); p = 0.05). The proportion of completed chemotherapy cycles was marginally lower in older patients (difference = -5%; 95% CI = (-9, 0.2); p = 0.06) for those ≥65 years versus <65 years, but no statistically significant difference occurred in the rate of chemotherapy discontinuation for toxicity (OR = 1.4; 95% CI = (0.85, 2.19); p = 0.21) for patients ≥65 years versus <65 years. A cutpoint of 70 years yielded similar results. CONCLUSION: These findings support carboplatin doublet-based chemotherapy in select older patients with advanced NSCLC.
Authors
Feliciano, JL; Le-Rademacher, JG; Gajra, A; Edelman, MJ; Zemla, T; McMurray, R; Chen, H; Hurria, A; Muss, H; Cohen, HJ; Lilenbaum, R; Jatoi, A
MLA Citation
URI
https://scholars.duke.edu/individual/pub1322280
PMID
29848457
Source
pubmed
Published In
J Geriatr Oncol
Volume
9
Published Date
Start Page
501
End Page
506
DOI
10.1016/j.jgo.2018.05.006

Purification of bovine milk xanthine oxidase

Authors
Rajagopalan, KV
MLA Citation
Rajagopalan, K. V. “Purification of bovine milk xanthine oxidase.” Handbook Methods for Oxygen Radical Research, 2018, pp. 21–23. Scopus, doi:10.1201/9781351072922.
URI
https://scholars.duke.edu/individual/pub1350930
Source
scopus
Published Date
Start Page
21
End Page
23
DOI
10.1201/9781351072922

Response to Letter From De Alfieri et al.: Biological Resilience of Elderly Hospitalized Patients.

Authors
Whitson, HE; Duan-Porter, W; Schmader, K; Morey, M; Cohen, HJ; Colón-Emeric, C
MLA Citation
Whitson, Heather E., et al. “Response to Letter From De Alfieri et al.: Biological Resilience of Elderly Hospitalized Patients..” J Gerontol a Biol Sci Med Sci, vol. 72, no. 1, Jan. 2017. Pubmed, doi:10.1093/gerona/glw161.
URI
https://scholars.duke.edu/individual/pub1157515
PMID
27811154
Source
pubmed
Published In
J Gerontol a Biol Sci Med Sci
Volume
72
Published Date
Start Page
142
DOI
10.1093/gerona/glw161

Comorbidity in older adults with cancer.

Comorbidity is an issue of growing importance due to changing demographics and the increasing number of adults over the age of 65 with cancer. The best approach to the clinical management and decision-making in older adults with comorbid conditions remains unclear. In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, met to discuss the design and implementation of intervention studies in older adults with cancer. A presentation and discussion on comorbidity measurement, interventions, and future research was included. In this article, we discuss the relevance of comorbidities in cancer, examine the commonly used tools to measure comorbidity, and discuss the future direction of comorbidity research. Incorporating standardized comorbidity measurement, relaxing clinical trial eligibility criteria, and utilizing novel trial designs are critical to developing a larger and more generalizable evidence base to guide the management of these patients. Creating or adapting comorbidity management strategies for use in older adults with cancer is necessary to define optimal care for this growing population.
Authors
Williams, GR; Mackenzie, A; Magnuson, A; Olin, R; Chapman, A; Mohile, S; Allore, H; Somerfield, MR; Targia, V; Extermann, M; Cohen, HJ; Hurria, A; Holmes, H
MLA Citation
Williams, Grant R., et al. “Comorbidity in older adults with cancer..” J Geriatr Oncol, vol. 7, no. 4, July 2016, pp. 249–57. Pubmed, doi:10.1016/j.jgo.2015.12.002.
URI
https://scholars.duke.edu/individual/pub1112763
PMID
26725537
Source
pubmed
Published In
J Geriatr Oncol
Volume
7
Published Date
Start Page
249
End Page
257
DOI
10.1016/j.jgo.2015.12.002