Some cancers are more common in elderly — often frail— persons, and Peter S. Hall, PhD, a medical oncologist from the University of Edinburgh, suggests that those points should be factored into the mix when calculating the best chemotherapy course. Known efficacy is only one consideration, he said as he explained the hypothesis for the GO2, a phase III trial of 514 patients with advanced gastroesophageal cancer.

He noted that most cancer trials that provide the evidence used in developing recommended treatments don’t include the frail elderly, yet gastroesophageal cancer is usually diagnosed at a late stage and the average age at diagnosis is 68. In the trial, patients were randomized to one of three regimens:

  • Level A was 130 mg/m2 of oxaliplatin given once every 21 days and a 625 mg/m2 dose of capecitabine twice a day given continuously;
  • Level B was 80% of Level A dosage;
  • Level C was 60% of Level A dosage.

After 9 weeks, patients were assessed for overall treatment utility. Bottom line: the lowest tested dose was noninferior to the highest dose in terms of delaying disease progression and minimizing side effects. And patients in that lowest dose reported the best quality of life. ASCO president Monica C. Bertagnolli, MD, said Hall’s study was a good example of the “less is more” approach to oncology, which is becoming more common since it is “paying off for patients’ quality of life.”

Abstract 4006: Optimizing chemotherapy for frail and elderly patients (pts) with advanced gastroesophageal cancer (aGOAC): The GO2 phase III trial.

Read the full ASCO 2019 RoundUp

The ASCO meeting, which kicks off May 31 in Chicago, will feature 2,400 abstracts, and another 3,200 submitted abstracts will be published online. Follow BreakingMED coverage at Physicians’ Weekly.


Peggy Peck, Editor-in-Chief at BreakingMED, a service of @Point of Care, LLC, which provides daily medical news reports curated to serve the unique needs of busy physicians and other healthcare professionals.