Chemotherapy for gastric cancer in elderly adults as effective as in younger patients
Chemotherapy schedules adapted to elderly advanced gastric cancer (AGC) patients provide noninferior efficacy compared with regimens used in younger patients, a recent study has found.
At the time of analysis, 1,213 fatal events were reported in the study cohort of 1,485 AGC patients. The median overall survival (OS) was 10.4 percent. Stratification by age group showed no significant differences in median OS between patients ≥70 vs <70 years (10.1 vs 10.8 months; p=0.158).
The 12-month OS rates were likewise statistically comparable in the ≥70 and <70 age groups (41.4 percent vs 45.1 percent). After complete adjustment for confounders such as tumour grade, metastasis, comorbidities and intervention strategies, the noninferiority hypothesis for OS was confirmed (hazard ratio [HR], 1.021; 95 percent CI, 0.913–1.141; p=0.018 for noninferiority).
A similar result was obtained for progression-free survival (PFS). Median PFS was similar between ≥70- and <70-year-olds (6.1 vs 5.8 months), and the noninferiority hypothesis was confirmed (HR, 0.9730; 0.876–1.081; p=0.002 for noninferiority. There were 1,182 progression events reported.
Researchers accessed real-world data from the national registry of Spain for consecutive AGC cases. There were 996 AGC patients <70 years (median age 59 years; 68.2 percent male) and 489 who were ≥70 years (median age 75 years; 73.4 percent male). The fixed margin method was used to statistically assess noninferiority.
In terms of chemotherapy use, triple-agent therapies were used much less in elderly adults than in younger counterparts (odds ratio, 0.39; 0.30–0.51; p<0.001). Double-agent therapies containing oxaliplatin appeared to be the treatment of choice. Modified schedules and lower doses were also more often employed in older adults.