Nathanael R. Fillmore
Themes / Frailty and Multimorbidity in Older Adults with Cancer
Line of work

Frailty and Multimorbidity in Older Adults with Cancer

This line of research examines the impact of physiologic reserve and chronic condition clusters on survival and treatment tolerance in elderly cancer patients. It emphasizes the development of the Veterans Affairs Frailty Index (VA-FI) as a scalable tool for clinical prognosis.

Electronic Frailty Index Frailty Geriatric Oncology Overall Survival

Anchor result

Moderate-to-severely frail patients with multiple myeloma derived the greatest survival benefit from intensive triplet therapy compared to doublet therapy.

Related publications

2026

Association of Frailty With Transfusions, Hospitalizations, and Survival in Patients With Myelodysplastic Syndrome Initiating Hypomethylating Agents.

Anahid Hamparsumian†, Jennifer La†, Mayuri Dharne, Gary Gilbert, Mary T. Brophy, Nhan V. Do, Dae Hyun Kim, Jane A. Driver, Nathanael R. Fillmore‡, Clark DuMontier‡† Equal first authorship · ‡ Equal senior authorship

EJHaem7(4), e70352
U.S. Veterans and VA Data Retrospective Cohort Study Frailty Overall Survival Hospitalization Metrics
2026

Frailty and survival outcomes in veterans with invasive cutaneous melanoma: A Veterans Affairs Cancer Registry retrospective cohort study.

Linden B. Huhmann†, Jonathan C. Hwang†, Daniel Y. Kim, Kaelyn Nannini, Nhan V. Do, John M. Gaziano, Lee E. Wheless, Nathanael R. Fillmore‡, Rebecca I. Hartman‡† Equal first authorship · ‡ Equal senior authorship

Journal of the American Academy of Dermatology95(1), 240-243
U.S. Veterans and VA Data Retrospective Cohort Study Cancer-Associated Thrombosis Cutaneous Melanoma Overall Survival
2025

Potentially Inappropriate Medications, Frailty, and Outcomes in Patients With Cancer Managed in a National Health Care System.

Jennifer La, Tammy Hshieh, Anahid Hamparsumian, Robert Zwolinski, Jameson Wood, Mayuri Dharne, J. Michael Gaziano, Mary T. Brophy, Nhan V. Do, Nikhil C. Munshi, Jane A. Driver, Gregory A. Abel, Nathanael R. Fillmore‡, Clark DuMontier‡‡ Equal senior authorship

Journal of the National Comprehensive Cancer Network23(9), 363-370
U.S. Veterans and VA Data Retrospective Cohort Study Electronic Health Records Frailty Overall Survival
2025

Multimorbidity and Its Impact in Older U.S. Veterans Newly Treated for Advanced Non-Small Cell Lung Cancer.

Joseph R. Larsen†, Chunlei Zheng†, Jennifer La, Julie Tsu-Yu Wu, Michael Kelley, J. Michael Gaziano, Mary Brophy, Nhan V. Do, Dae H. Kim, Jane A. Driver, Clark DuMontier‡, Nathanael R. Fillmore‡† Equal first authorship · ‡ Equal senior authorship

Annals of the American Thoracic Society22(4), 598-608
U.S. Veterans and VA Data Retrospective Cohort Study Lung Cancer Overall Survival Geriatric Oncology
2023

Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.

Clark DuMontier†, Robert Hennis†, Cenk Yilidirim, Benjamin J. Seligman, Valencia Carolina Fonseca, Brooke L. Lubinski, Stephanie M. Sison, Mayuri Dharne, Dae Hyun Kim, Andrea Wershof Schwartz, Jane A. Driver, Nathanael R. Fillmore‡, Ariela R. Orkaby‡† Equal first authorship · ‡ Equal senior authorship

Journal of the American Geriatrics Society71(12), 3857-3864
U.S. Veterans and VA Data Electronic Health Records Frailty Electronic Frailty Index Construct Validity
2023

More intensive therapy as more effective treatment for frail patients with multiple myeloma [corrected].

Clark DuMontier†, Jennifer La†, John Bihn, June Corrigan, Cenk Yildirim, Mayuri Dharne, Hamza Hassan, Sarvari Yellapragada, Gregory A. Abel, J. Michael Gaziano, Nhan V. Do, Mary Brophy, Dae H. Kim, Nikhil C. Munshi, Nathanael R. Fillmore‡, Jane A. Driver‡† Equal first authorship · ‡ Equal senior authorship

Blood Advances7(20), 6275-6284
U.S. Veterans and VA Data Retrospective Cohort Study Multiple Myeloma Frailty Overall Survival
2021

Evaluating the impact of age on immune checkpoint therapy biomarkers.

Rossin Erbe, Zheyu Wang, Sharon Wu, Joanne Xiu, Neeha Zaidi, Jennifer La, David Tuck, Nathanael Fillmore, Nicolas A. Giraldo, Michael Topper, Stephen Baylin, Marc Lippman, Claudine Isaacs, Reva Basho, Ilya Serebriiskii, Heinz-Josef Lenz, Igor Astsaturov, John Marshall, Josephine Taverna, Jerry Lee, Elizabeth M. Jaffee, Torres Evanthia T. Roussos, Ashani Weeraratna, Hariharan Easwaran, Elana J. Fertig

Cell Reports36(8), 109599
Age Factors Biomarkers Comparative Analysis Genomic Analysis Immune Checkpoint Inhibitors
2021

Defining Multimorbidity and Its Impact in Older United States Veterans Newly Treated for Multiple Myeloma.

Nathanael R. Fillmore†, Clark DuMontier†, Cenk Yildirim, Jennifer La, Mara M. Epstein, David Cheng, Diana Cirstea, Sarvari Yellapragada, Gregory A. Abel, J. Michael Gaziano, Nhan Do, Mary Brophy, Dae H. Kim, Nikhil C. Munshi, Jane A. Driver† Equal first authorship

Journal of the National Cancer Institute113(8), 1084-1093
U.S. Veterans and VA Data Retrospective Cohort Study Multiple Myeloma Overall Survival Geriatric Oncology
2021

Contemporary Analysis of Electronic Frailty Measurement in Older Adults with Multiple Myeloma Treated in the National US Veterans Affairs Healthcare System.

Clark DuMontier†, Nathanael R. Fillmore†, Cenk Yildirim, David Cheng, Jennifer La, Ariela R. Orkaby, Brian Charest, Diana Cirstea, Sarvari Yellapragada, John Michael Gaziano, Nhan Do, Mary T. Brophy, Dae H. Kim, Nikhil C. Munshi, Jane A. Driver† Equal first authorship

Cancers13(12)
U.S. Veterans and VA Data Retrospective Cohort Study Electronic Health Records Multiple Myeloma Frailty
2021

Updating and Validating the U.S. Veterans Affairs Frailty Index: Transitioning From ICD-9 to ICD-10.

David Cheng†, Clark DuMontier†, Cenk Yildirim, Brian Charest, Chelsea E. Hawley, Min Zhuo, Julie M. Paik, Enzo Yaksic, J. Michael Gaziano, Nhan Do, Mary Brophy, Kelly Cho, Dae H. Kim, Jane A. Driver, Nathanael R. Fillmore‡, Ariela R. Orkaby‡† Equal first authorship · ‡ Equal senior authorship

Journals of Gerontology: Series A76(7), 1318-1325
U.S. Veterans and VA Data Electronic Health Records Frailty Electronic Frailty Index ICD-10 Coding