Reducing doses and adjusting chemotherapy schedules in older patients with advanced cancer may help improve treatment tolerability without compromising its efficacy, according to a recent study published by Mohamed et al in JAMA Network Open.
Background
Standard chemotherapy regimens—mostly based on testing in relatively young and healthy patients—may lower quality of life and functionality in older patients with cancer who often struggle with other health issues.
Study Methods and Results
In the recent study, investigators analyzed the outcomes of over 600 patients over 70 years of age who participated in the GAP70+ trial—with the goal of determining how well older patients tolerate chemotherapy.
Nearly 50% of the patients who participated in the study received a modified chemotherapy regimen, defined as any treatments that deviated from the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology or published clinical trials. Lower doses and altered chemotherapy schedules were the most common modifications observed in the study.
The investigators found that more than 30% of the patients benefited from modified chemotherapy regimens that helped them avoid toxic side effects and retain the ability to perform daily functions such as bathing, dressing, eating, and walking. Compared with those who received standard treatment regimens, the patients who received the modified chemotherapy regimens had a 15% reduced risk of serious clinician-rated toxic effects, a 20% reduced risk of patient-reported functional declines, and a 32% reduced risk of worse composite adverse outcomes—suggesting that the modified regimens did not compromise treatment efficacy.
Conclusions
The research was among a number of recent studies exclusively focusing on older patients who received chemotherapy. The investigators hope their findings can help health-care providers select the most effective care strategies for older patients with advanced cancer.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
