Martine Extermann, MD, PhD

Dr. Extermann’s work seeks to understand how general health of the older patient interacts with cancer behavior, and conduct and outcomes of their cancer treatment. She works on designing models that intertwine geriatric assessment and oncology decision tools.  She has designed a model for estimating the benefit from adjuvant therapy in older breast cancer patients, adjusting for comorbidity. She has also devised an index that allows assessing the individual risk of severe toxicity from chemotherapy: the Chemotherapy Risk Assessment Scale for High-age patients (CRASH) score. She is conducting studies to explore the interaction of comorbidity with cancer behavior and treatment.

• Muffly LS, Boulukos M, Swanson K, Kocherginsky M, Cerro PD, Schroeder L, Pape L, Extermann M, Van Besien K, Artz AS. Pilot Study of Comprehensive Geriatric Assessment (CGA) in Allogeneic Transplant: CGA Captures a High Prevalence of Vulnerabilities in Older Transplant Recipients. Biol Blood Marrow Transplant. 2013 Mar;19(3):429-434. Pubmedid: 23160006.
• Extermann M. Metabolic syndrome and cancer: from bedside to bench and back. Interdiscip Top Gerontol. 2013;38:49-60. Pubmedid: 23503515.
• Extermann M. Integrating a geriatric evaluation in the clinical setting. Semin Radiat Oncol. 2012 Oct;22(4):272-276. Pubmedid: 22985809.
• Chen RC, Royce TJ, Extermann M, Reeve BB. Impact of age and comorbidity on treatment and outcomes in elderly cancer patients. Semin Radiat Oncol. 2012 Oct;22(4):265-271. Pubmedid: 22985808.
• Movsas B, Extermann M. Introduction: cancer, aging, and comorbidities. Semin Radiat Oncol. 2012 Oct;22(4):263-264. Pubmedid: 22985807.
• Extermann M, Boler I, Reich RR, Lyman GH, Brown RH, DeFelice J, Levine RM, Lubiner ET, Reyes P, Schreiber FJ, Balducci L. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 2012 Jul;118(13):3377-3386. Pubmedid: 22072065.
• Dale W, Mohile SG, Eldadah BA, Trimble EL, Schilsky RL, Cohen HJ, Muss HB, Schmader KE, Ferrell B, Extermann M, Nayfield SG, Hurria A. Biological, clinical, and psychosocial correlates at the interface of cancer and aging research. J Natl Cancer Inst. 2012 Jun;104(8):581-589. Pubmedid: 22457474. Pmcid: PMC3328422.
• Hurria A, Browner IS, Cohen HJ, Denlinger CS, deShazo M, Extermann M, Ganti AK, Holland JC, Holmes HM, Karlekar MB, Keating NL, McKoy J, Medeiros BC, Mrozek E, O'Connor T, Petersdorf SH, Rugo HS, Silliman RA, Tew WP, Walter LC, Weir AB, Wildes T. Senior adult oncology. J Natl Compr Canc Netw. 2012 Feb;10(2):162-209. Pubmedid: 22308515. Pmcid: PMC3656650.
• Liu JJ, Extermann M. Comprehensive geriatric assessment and its clinical impact in oncology. Clin Geriatr Med. 2012 Feb;28(1):19-31. Pubmedid: 22326033.
• Extermann M, Wedding U. Comorbidity and geriatric assessment for older patients with hematologic malignancies: a review of the evidence. J Geriatr Oncol. 2012;3:50-57.
• Extermann M. Basic Assessment of the Older Cancer Patient. Curr Treat Options Oncol. 2011 Sep;12(3):276-285. Pubmedid: 21656152.
• Janssen-Heijnen ML, Extermann M, Boler IE. Can first cycle CBCs predict older patients at very low risk of neutropenia during further chemotherapy?. Crit Rev Oncol Hematol. 2011 Jul;79(1):43-50. Pubmedid: 20685130.
• Brunello A, Kapoor R, Extermann M. Hyperglycemia during chemotherapy for hematologic and solid tumors is correlated with increased toxicity. Am J Clin Oncol. 2011 Jun;34(3):292-296. Pubmedid: 20622641.
• Gore E, Bae K, Langer C, Extermann M, Movsas B, Okunieff P, Videtic G, Choy H. Phase I/II Trial of a COX-2 Inhibitor With Limited Field Radiation for Intermediate Prognosis Patients Who Have Locally Advanced Non-Small-Cell Lung Cancer: Radiation Therapy Oncology Group 0213. Clin Lung Cancer. 2011 Mar;12(2):125-130. Pubmedid: 21550559.
• van Waalwijk MA, van de Schans SAM, Haak HR, Extermann M, Derckson MW, Janssen-Heijnen MLG. Diabetes alone should not be a motive for withholding adjuvant chemotherapy for stage III colon cancer. J Comorbid. 2011;1:19-27.
• Kumar NB, Kazi A, Smith T, Crocker T, Yu D, Reich RR, Reddy K, Hastings S, Exterman M, Balducci L, Dalton K, Bepler G. Cancer cachexia: traditional therapies and novel molecular mechanism-based approaches to treatment. Curr Treat Options Oncol. 2010 Dec;11(3-4):107-117. Pubmedid: 21128029. Pmcid: PMC3016925.
• Extermann M, Crane EJ, Boulware D. Cancer in nonagenarians: Profile, treatments and outcomes. Crit Rev Oncol Hematol. 2010 Aug;75(2):160-164. Pubmedid: 20656211.
• Hurria A, Cohen HJ, Extermann M. Geriatric Oncology Research in the Cooperative Groups: A Report of a SIOG Special Meeting. J Geriatr Oncol. 2010 Jun;1(1):40-44. Pubmedid: 21218146.
• Extermann M. Geriatric oncology: an overview of progresses and challenges. Cancer Res Treat. 2010 Jun;42(2):61-68. Pubmedid: 20622959.
• Robb C, Boulware D, Overcash J, Extermann M. Patterns of care and survival in cancer patients with cognitive impairment. Crit Rev Oncol Hematol. 2010 Jun;74(3):218-224. Pubmedid: 19709899.
• Extermann M. Larger questions about chemotherapy in older patients. Oncology (Williston Park). 2010 Jan;24(1):92-93. Pubmedid: 20187327.
• Extermann M, Crane EJ, Boulware D. Cancer in nonagenarians: Profile, treatments and outcomes. Crit Rev Oncol Hematol. 2009 Aug;. Pubmedid: 19720543.
• Luciani A, Jacobsen P, Extermann M, Foa P, Marussi D, Overcash J, BalducciL. Fatigue and functional dependence in older cancer patients. Am J Clin Oncol. 2008 Oct;31(5):424-430. Pubmedid: 18838877.
• Simon GR, Extermann M, Chiappori A, Williams CC, Begum M, Kapoor R, Haura EB, Ismail-Khan R, Schell MJ, Antonia SJ, Bepler G. Phase 2 trial of docetaxel and gefitinib in the first-line treatment of patients with advanced nonsmall-cell lung cancer (NSCLC) who are 70 years of age or older. Cancer. 2008 May;112(9):2021-2029. Pubmedid: 18300255.
• Wildiers H, Kunkler I, Biganzoli L, Fracheboud J, Vlastos G, Bernard-Marty C, Hurria A, Extermann M, Girre V, Brain E, Audisio R, Bartelink H, Barton M, Giordano S, Muss H, Aapro M. Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology. Lancet Oncol. 2007 Dec;8(12):1101-1115. Pubmedid: 18054880.
• Extermann M, Hurria A. Comprehensive geriatric assessment for older patients with cancer. J Clin Oncol. 2007 May;25(14):1824-1831. Pubmedid: 17488980.
• Robb C, Haley W, Balducci L, Extermann M, Perkins E, Small B, Mortimer J. Impact of breast cancer survivorship on quality of life in older women. Crit Rev Oncol Hematol. 2007 Apr;62(1): 84-91. Pubmedid: 17188505.
• Perkins EA, Small BJ, Balducci L, Extermann M, Robb C, Haley WE. Individual differences in well-being in older breast cancer survivors. Crit Rev Oncol Hematol. 2007 Apr;62(1):74-83. Pubmedid: 17240157. Pmcid: PMC1911161.
• Extermann M. Connecting trains. Cancer Control. 2007 Jan;14(1):4-5. Pubmedid: 17242665.
• Extermann M. Interaction between comorbidity and cancer. Cancer Control. 2007 Jan;14(1):13-22. Pubmedid: 17242667.
• Extermann M. Treating advanced breast cancer in the older woman. Oncology (Williston Park). 2006 Oct;20(11):1355-1360. Pubmedid: 17111999.
• Overcash J, Beckstead J, Moody L, Extermann M, Cobb S. The abbreviated comprehensive geriatric assessment (aCGA) for use in the older cancer patient as a prescreen: Scoring and interpretation. Crit Rev Oncol Hematol. 2006 Aug;59(3):205-210. Pubmedid: 16904902.
• Artz A, Pollyea D, Kocherginsky M, Stock W, Rich E, Odenike O, ZimmermanT, Smith S, Godley L, Thirman M, Daugherty C, Extermann M, Larson R, van BesienK. Performance status and comorbidity predict transplant-related mortality after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2006 Aug;12(9):954-964. Pubmedid: 16920562.
• Extermann M. Geriatric assessment with focus on instrument selectivity for outcomes. Cancer J. 2005 Nov;11(6):474-480. Pubmedid: 16393481.
• Extermann M, Aapro M, Bernabei R, Cohen H, Droz J, Lichtman S, Mor V, Monfardini S, Repetto L, Sorbye L, Topinkova E. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005 Oct;55(3):241-252. Pubmedid: 16084735.
• Naing A, Luong D, Extermann M. Methotrexate-induced status epilepticus. Am J Hematol. 2005 Aug;80(1):35-37. Pubmedid: 16138356.
• Carreca I, Balducci L, Extermann M. Cancer in the older person. Cancer Treat Rev. 2005 Aug;31(5):380-402. Pubmedid: 15967582.
• Extermann M. Older patients, cognitive impairment, and cancer: an increasingly frequent triad. J Natl Compr Canc Netw. 2005 Jul;3(4):593-596. Pubmedid: 16038648.
• Mandelblatt JS, Schechter CB, Yabroff KR, Lawrence W, Dignam J, Extermann M, Fox S, Orosz G, Silliman R, Cullen J, Balducci L. Toward optimal screening strategies for older women. Costs, benefits, and harms of breast cancer screening by age, biology, and health status. J Gen Intern Med. 2005 Jun;20(6):487-496. Pubmedid: 15987322. Pmcid: PMC1490138.
• Overcash J, Beckstead J, Extermann M, Cobb S. The abbreviated comprehensive geriatric assessment (aCGA): a retrospective analysis. Crit Rev Oncol Hematol. 2005 May;54(2):129-136. Pubmedid: 15843095.
• Extermann M, Chen H, Booth-Jones M, Meyer J, Balducci L, Jacobsen P. Pilot testing of the computerized cognitive test Microcog in chemotherapy-treated older cancer patients. Crit Rev Oncol Hematol. 2005 May;54(2):137-143. Pubmedid: 15843096.
• Aapro M, Kohne C, Cohen H, Extermann M. Never too old? Age should not be a barrier to enrollment in cancer clinical trials. Oncologist. 2005 Mar;10(3):198-204. Pubmedid: 15793223.
• Extermann M. Biological basis of the association of cancer and aging comorbidity. Cancer Treat Res. 2005;124:173-186. Pubmedid: 15839196.
• Extermann M. Decision analysis for cancer prevention and cancer treatment in the elderly. Cancer Treat Res. 2005;124:223-232. Pubmedid: 15839198.
• Braud A, Extermann M. Biological screening and impact in elderly cancer patients. Cancer Treat Res. 2005;124:165-171. Pubmedid: 15839195.
• Extermann M, Meyer J, McGinnis M, Crocker T, Corcoran M, Yoder J, Haley W, Chen H, Boulware D, Balducci L. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Crit Rev Oncol Hematol. 2004 Jan;49(1):69-75. Pubmedid: 14734156.
• Extermann M. Management issues for elderly patients with breast cancer. Curr Treat Options Oncol. 2004;5(2):161-169. Pubmedid: 14990210.
• Extermann M. Paclitaxel pharmacokinetics, threshold models, and dosing strategies. J Clin Oncol. 2003;21(14):2804-2806. Pubmedid: 12860962.
• Extermann M. Studies of comprehensive geriatric assessment in patients with cancer. Cancer Control. 2003;10(6):463-468. Pubmedid: 14652522.
• Extermann M, Balducci L. Optimizing cancer care in the elderly: progress in geriatric oncology. Cancer Control. 2003;10(6):440-441. Pubmedid: 14652519.
• Chen H, Cantor A, Meyer J, Corcoran M, Grendys E, Cavanaugh D, AntonekS, Camarata A, Haley W, Balducci L, Extermann M. Can older cancer patients tolerate chemotherapy? A prospective pilot study. Cancer. 2003;97(4):1107-1114. Pubmedid: 12569613.
• Extermann M, Albrand G, Chen H, Zanetta S, Schonwetter R, Zulian G, Cantor A, Droz J. Are older french patients as willing as older american patient to undertake chemotherapy?. J Clin Oncol. 2003;21(17):3214-3219. Pubmedid: 12874269.
• Extermann M. Comprehensive geriatric assessment basics for the cancer professional. J Oncol Manag. 2003;12(2):13-17. Pubmedid: 12699111.
• Friberg M, Jennings R, Alsarraj M, Dessureault S, Cantor A, Extermann M, Munn DH, Antonia SJ, Mellor AL. Indoleamine 2,3-dioxygenase contributes to tumor cell evasion of T cell-mediated rejection. Int J Cancer. 2002 Sep;101(2):151-155. Pubmedid: 12209992.
• Extermann M, Chen H, Cantor A, Corcoran M, Meyer J, Grendys E, CavanaughD, Antonek S, Camarata A, Haley W, Balducci L. Predictors of tolerance to chemotherapy in older cancer patients: a prospective pilot study. Eur J Cancer. 2002;38(11):1466-1473. Pubmedid: 12110492.
• Extermann M. Comorbidity and geriatric assessment in the elderly patient over the age of 70. Tumori. 2002;88(1):S9-S9. Pubmedid: 11989938.
• Antonia S, Seigne J, Diaz J, Muro-Cacho C, Extermann M, Farmelo M, Friberg M, Alsarraj M, Mahany J, Pow-Sang J, Cantor A, Janssen W. Phase I trial of a B7-1 (CD80) gene modified autologous tumor cell vaccine in combination with systemic interleukin-2 in patients with metastatic renal cell carcinoma. J Urol. 2002;167(5):1995-2000. Pubmedid: 11956426.
• Overcash J, Extermann M, Parr J, Perry J, Balducci L. Validity and reliability of the FACT-G scale for use in the older person with cancer. Am J Clin Oncol. 2001;24(6):591-596. Pubmedid: 11801761.
• Balducci L, Extermann M, Carreca I. Management of breast cancer in the older woman. Cancer Control. 2001;8(5):431-441. Pubmedid: 11579340.
• Balducci L, Extermann M. A practical approach to the older patient with cancer: a review. Curr Probl Cancer. 2001;25(1):6-76. Pubmedid: 11261937.
• Extermann M. Challenges in geriatric oncology. Cancer Control. 2000;7(6):499-500. Pubmedid: 11088059.
• Extermann M. Measurement and impact of comorbidity in older cancer patients. Crit Rev Oncol Hematol. 2000;35(3):181-200. Pubmedid: 10960800.
• Mandelblatt J, Orosz G, Yabroff K, Extermann M, Lawrence W, Yi B, Satariano W, Bloom H, Fox S, Silliman R, Fahs M, Schecther C, Muenning P, Balducci L. Screening mammography in elderly women. Research on Breast Cancer in Older Women Consortium. Jama. 2000;283(24):3202-3203. Pubmedid: 10866863.
• Extermann M, Aapro M. Assessment of the older cancer patient. Hematol Oncol Clin North Am. 2000;14(1):63-77. Pubmedid: 10680072.
• Balducci L, Extermann M. Management of the frail person with advanced cancer. Crit Rev Oncol Hematol. 2000;33(2):143-148. Pubmedid: 10737376.
• Aapro M, Extermann M, Repetto L. Evaluation of the elderly with cancer. Ann Oncol. 2000;11:223-229. Pubmedid: 11079145.
• Extermann M. Measuring comorbidity in older cancer patients. Eur J Cancer. 2000;36(4):453-471. Pubmedid: 10717521.
• Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist. 2000;5(3):224-237. Pubmedid: 10884501.
• Extermann M, Balducci L, Lyman G. What threshold for adjuvant therapy in older breast cancer patients?. J Clin Oncol. 2000;18(8):1709-1717. Pubmedid: 10764431.
• Balducci L, Extermann M. Cancer and aging. An evolving panorama. Hematol Oncol Clin North Am. 2000;14(1):1-16. Pubmedid: 10680068.
• Balducci L, Extermann M. Cancer in the elderly. Clin Geriatr Med. 1999;6(13):51-58. Pubmedid: noPMID.
• Extermann M, Overcash J, Lyman G, Parr J, Balducci L. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol. 1998;16(4):1582-1587. Pubmedid: 9552069.
• Balducci L, Extermann M. Difficulties in treating older patients with cancer. Oncology Pract. 1998;15-18. Pubmedid: noPMID.
• Extermann M, Bacchi M, Monai N, Fopp M, Fey M, Tichelli A, Schapira M, Spertini O. Relationship between cleaved L-selectin levels and the outcome of acute myeloid leukemia. Blood. 1998;92(9):3115-3122. Pubmedid: 9787146.
• Antonia S, Extermann M, Flavell R. Immunologic nonresponsiveness to tumors. Critical Rev Onco. 1998;9:35-41. Pubmedid: 9754446.
• Balducci L, Extermann M. Cancer chemotherapy in the older person: what the medical oncologists needs to know. Cancer. 1997;80:1317-1322. Pubmedid: 9317185.
• Balducci L, Extermann M. Advances in cancer therapy for the older patient. Intern Med. 1997;18:79-92. Pubmedid: noPIMID.
• Patterson S, Benson K, Balducci L, Extermann M, Lyman G. 1997;137b.
• Extermann M. Acute leukemia in the elderly. Clin Geriatr Med. 1997;13:227-244. Pubmedid: 9103206.
• Balducci L, Extermann M, Fentiman I, Monfardini S, Perrone F. Should adjuvant chemotherapy be used to treat breast cancer in elderly patients (> or = 70 years of age)?. Eur J Cancer. 1997;33:1720-1724. Pubmedid: 9470824.
• Extermann M, Balducci L, Lyman G. Optimal duration of adjuvant tamoxifen treatment in elderly breast cancer patients: influence of age, cormorbidites, and various effectiveness hypothesis on life-expectancy. Breast Dis. 1996;9:327-339.
• Extermann M, Vogt N, Forni M, Dayer P. Radiation recall in a patient with breast cancer treated for tuberculosis. Eur J Clin Pharm. 1995;48:77-78. Pubmedid: 7621852.
• Zulian G, Roux E, Tiercy J, Extermann M, Diebold-Berger S, Reymond J, Helg C, Zubler R, Betticher D, Alberto P, Jeannet M, Chapuis B. Transfusion associated graft versus host disease in a patient treated with cladribine (2-chlorodeoxyadenosine): demonstration of exogenous DNA in various tissue extracts. Brit J Hemat. 1995;89:83-89. Pubmedid: 7833282.
• Extermann M, C Regamey, L Humair, Murisier F, Rhyner K, Vonwiller H. Initial treatment of sepsis in non-neutropenic patients: ceftazidime alone versus "best guess" combined antibiotic therapy. Chemotherapy. 1995;41:306-315. Pubmedid: 7555212.
• Extermann M, Regamey C. Empirical antibiotic treatment of sepsis in non-neutropenic patients: single agent or combination therapy?. Infection. 1994;22:1-3.
• Hayoz D, Extermann M, Odermatt B, Pugin P, Regamey C, Knecht H. Familial primary gastric lymphoma. Gut. 1993;34:136-140.
• Balducci L, Extermann M. The cost of cancer prevention and treatment in the older person. In: The older cancer patient. New York, NY: Springer Publishing Company Inc; 2003;284-296.
• International issues. In: Extermann M, Aapro M, eds. Cancer in the elderly. New York, NY: Marcel Dekker; 2000;459-476.
• Extermann M, Bonetti M, Sledge G, O'Dwyer P, Bonomi P, Benson AB 3rd. MAX2--a convenient index to estimate the average per patient risk for chemotherapy toxicity; validation in ECOG trials. Eur J Cancer. 2004;40(8):1193-1198. Pubmedid: 15110883.
• Balducci L, Extermann M. Issues in the care of the older cancer patient: delayed diagnosis, inadequate treatment, and information gaps. In: The older cancer patient. New York, NY: Springer Publishing Company Inc; 2003;24-44.
• Balducci L, Extermann M. Cancer and age. In: Haskell C, ed. Cancer treatment. Philadelphia, PA: W.B. Saunders; 2000;435-451.
• Extermann M, Balducci L. Practical proposals for clinical protocols in elderly patients with cancer. In: Balducci L, Lyman G, Ershler W, et al, eds. Comprehensive Geriatric Oncology. Amsterdam. Harwood Academic Publishers; 1998;263-269.
• Balducci L, Extermann M. Cancer, carcinogenesis and aging. In: Rosenthal R, Zenilman M, Katlic M, et al, eds. Principles and practice of geriatric surgery. New York, NY: Springer Publishing Co Verlag; 2000;38-45.