Older adults with resectable gastric cancer undergoing perioperative chemotherapy or preoperative chemoradiotherapy plus perioperative chemotherapy: A secondary analysis of the AGITG TOPGEAR phase III trial.
Alexander Rühle, Alina Krause, Rachel L O'Connell et al.
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In 30 seconds
This secondary analysis of the AGITG TOPGEAR phase III trial evaluated older adults (≥70 years) with resectable gastric cancer undergoing perioperative chemotherapy or chemoradiotherapy. Among 574 patients, 135 were older adults, who showed similar overall survival (OS) and progression-free survival (PFS) compared to younger patients, despite requiring more treatment modifications and experiencing higher rates of hematologic toxicity.
Key findings
- Older adults required preoperative chemotherapy dose reductions or delays more frequently (chemoradiotherapy: 55% vs 35%, p=0.004).
- Rates of grade ≥3 adverse events were similar between age groups (chemotherapy: 68% vs 59%, p=0.220).
- Older adults had higher rates of hematologic toxicity (56% vs 37%, p=0.006) and grade ≥3 diarrhea (21% vs 6%, p<0.001).
- Overall survival was comparable across age groups, with HR 0.86 for chemoradiotherapy and HR 0.75 for chemotherapy.
Why it matters
Understanding treatment adherence and outcomes in older adults with gastric cancer is crucial, as this population often faces unique challenges. The findings suggest that older patients can achieve similar oncologic outcomes as younger patients, which may influence treatment decisions.