Objectives	To be able to recognise comorbidities, their burden, adapt treatment in collaboration with the organ specialists To be able to guide systemic therapy in patients with comorbidities
Key Concepts	Recognise comorbidities and evaluate the impact on cancer treatment (efficacy and toxicity) Demonstrate an understanding of how comorbidities affect the pharmacokinetics and pharmacodynamics of cancer drugs Distinguish key drug interactions in terms of comorbidities, drugs, and cancer treatments Recognise the difference between comorbidities, Eastern Cooperative Oncology Group performance status and functional status Give examples of comorbidities and the impact on life expectancy and instruments to assess that Recognise the role of interdisciplinary management of comorbidities to improve cancer treatment feasibility Demonstrate an understanding of how in older patients interdisciplinary management should be integrated in a comprehensive geriatric assessment and management plan for best outcomes Demonstrate an understanding of how to individualise the management of different types and stages of cancer in patients with comorbidities Define comorbidities and related contraindications to specific cancer treatments Evaluate role of comorbidities in clinical trial design and enrolment and external validity Demonstrate an understanding of how cancer-directed treatment can lead to the exacerbation of comorbidities during or after the completion of therapy
Skills	Demonstrate the ability to: Perform a thorough and accurate assessment of a patient with cancer’s comorbid medical conditions  Critically discuss and coordinate the management of comorbidities of patients with cancer with other specialists  Apply understanding of drug pharmacology to adapt and modify therapeutic plans in patients with cancer with comorbidities, including varying degrees of hepatic and renal dysfunction  Evaluate whether comorbidities allow trial eligibility or not and whether they are part of a pattern of frailty and unfitness or not  Incorporate comorbidities in determining the risk/benefit ratio for pursuing cancer-directed therapy and for specific anti-cancer agents and procedures  Predict potential acute and chronic treatment-related complications (eg, neuropathy) and initiate pro-active supportive care in patients with cancer and comorbidities  Participate actively in the management of patients with cancer and comorbidities at the time of diagnosis, and during the initiation, transition, and cessation of treatment  Discuss and leverage local oncogeriatric resources to provide an integrated care plan for older patients with comorbidities