Optimizing Chemotherapy for Frail and/or Elderly Patients With Advanced Gastroesophageal Cancer (Agoac): The Go2 Phase Iii Trial

Swinson, Daniel; Hall, Pauline de la Μ.; Lord, Stephen R.; Marshall, Henry; Ruddock, Sharon; Allmark, Christine; Cairns, David A.; Waters, Jill; Wadsley, Jonathan; Falk, S.; Roy, Roshni; Joseph, Mano; Nicoll, J. J.; Kamposioras, K.; Tillett, Tania; Cummins, Sebastian; Grumett, Simon; Stokes, Zuzana; Waddell, Tracy; Chatterjee, Anindya; García, Angie; Khan, Mumtaz Ahmad; Petty, Ross E.; Seymour, M

doi:10.1016/s1879-4068(19)31133-6

Cited by 3 publications

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“…It was found that the survival benefit of the treatment mode of the combined administration (increasing chemotherapeutic drugs or combined targeted drugs) was outstanding, whereas the incidence of adverse reactions was increased. The elderly and frail patient population is more prone to the development of adverse reactions and exhibits higher therapeutic utility in low-dose intensive chemotherapy (74). The exploration of the optimal treatment scheme and DI for different populations requires substantial research in order to maximize the effectiveness of clinical treatment.…”

Section: Discussionmentioning

confidence: 99%

Management of chemotherapy dose intensity for metastatic colorectal cancer (Review)

2022

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Chemotherapy dose intensity is a momentous parameter of antitumor clinical medication. In certain clinical trials, the actual application dose of the chemotherapeutic drugs is frequently different from the prescribed dose. The chemotherapy dose intensity completed in different trials is also variable, which has an impact on the treatment efficacy, disease prognosis and patient safety. When these agents are tested in the population, chemotherapy reduction and delay or failure to complete the planned cycle constantly occur due to age, performance status, adverse reactions and other reasons, resulting in the modification of the chemotherapy dose intensity. The present review analyzed the correlation between the chemotherapy dose intensity and the incidence of adverse reactions, the treatment efficacy and disease prognosis in clinical trials of metastatic colorectal cancer. Moreover, the clinical applications of chemotherapy dose intensity were discussed. Based on individual differences, the present review analyzed the clinical trials that examined the efficacy of the chemotherapy dose intensity in different patient populations. The conclusions suggested that different populations require a specific dose intensity to reduce treatment toxicity without affecting the curative effect. Contents 1. Introduction 2. Three-drug combination chemotherapy regimens 3. Two-drug combination chemotherapy regimens 4. DI of specific populations 5. Conclusion

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Section: Discussionmentioning

confidence: 99%

Management of chemotherapy dose intensity for metastatic colorectal cancer (Review)

2022

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“…Biweekly XELOX (oxaliplatin 85mg/ 2 day 1, capecitabine 900-1800mg/m 2 bid day 1 to 10, every 2 weeks) was demonstrated that could bring a better tolerance and satisfactory therapeutic effects in the untreated advanced colorectal cancer and gastric cancer patients, especially for the elderly patients [10][11] . Furthermore, compared with the patients accepted standard 3-weekly XELOX (HR 1.10, 95% CI, 0.90-1.33), the counterparts received modi ed 3-weekly XELOX with does intensity reduction (HR 1.09, 95% CI, 0.89-1.32) could acquire a similar PFS bene t, in the advanced gastric cancer patients with a median age of 76 years [12] . The patients undertook 60% of the standard does showed a higher satisfaction in the quality of life and objective effectiveness (43% vs. 35%) [12] .…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, compared with the patients accepted standard 3-weekly XELOX (HR 1.10, 95% CI, 0.90-1.33), the counterparts received modi ed 3-weekly XELOX with does intensity reduction (HR 1.09, 95% CI, 0.89-1.32) could acquire a similar PFS bene t, in the advanced gastric cancer patients with a median age of 76 years [12] . The patients undertook 60% of the standard does showed a higher satisfaction in the quality of life and objective effectiveness (43% vs. 35%) [12] . Moreover, metronomic chemotherapy was revealed to lead a lower toxicity and satisfactory survival bene t in lung cancer and breast cancer patients by reducing single does or shortening the intermission of chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Biweekly Oxaliplatin Plus S1 (SOX) As First Line Therapy For Advanced Or Metastatic Gastric Or Gastroesophageal Junction (G/GEJ) Caner In Chinese Elderly Patients: An Open-Label, Single-Arm, Phase 2 Study.

Jiang

Zhou

Sun

et al. 2021

Preprint

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Background: SOX (oxaliplatin and S1 every 3 weeks) is one of the most common used first line chemotherapy for advanced or metastatic G/GEJ cancer in Asia, but with significant hematological and neurological toxicity. In China, the majority of gastric cancer patients are the middle-aged and elderly with dissatisfactory tolerance to 3-weekly chemotherapy. Therefore, we aimed to assess efficacy and safety of biweekly SOX as first line treatment in patients 60 years old or older with advanced G/GEJ cancer in a single arm phase 2 study. Methods: Oxaliplatin was administered intravenously on day 1 at 85 mg/m2. S-1 was given at 80, 100, 120 mg/day depending on body surface area of <1.25 m2, 1.25 to <1.5 m2, or ≥1.5 m2 two times daily on days 1-10, every 2 weeks. Eligible patients were aged 60 years old or older with histological or cytological diagnosis of advanced G/GEJ adenocarcinoma, had measurable disease according to the RECIST v 1.1 without previous treatment. The primary endpoint was objective response rate (ORR), and the secondary endpoints included progression free survival (PFS), overall survival (OS), disease control rate (DCR), duration of response (DOR) and safety. Results: Between May 2016 and Sep 2018, 42 patients were enrolled. Median follow-up time was 43.6 months. ORR and DCR were 52.4% and 85.7%, respectively. Median PFS was 4.6 months (95%CI 2.486-6.714). Median OS was 11.1 months (95%CI 8.001-14.199). The most common treatment-related adverse events (TRAEs) of any grade were thrombocytopenia (59.5%), neutropenia (57.1%), appetite loss (57.1%) and nausea (54.8%). Only two patients respectively suffered from grade 3 treatment-related neutropenia (1 patient, [2.4%]) and diarrhea (1 patient, [2.4%]). No other grade 3 or worse TRAEs occurred. Conclusions: First line biweekly SOX showed promising PFS and OS with a remarkable tolerance in advanced G/GEJ cancer patients 60 years old or older preliminary worth further evaluation.Trial registration: ClinicalTrials.gov ID: NCT04694404 (5/1/2021). This study was approved by the Ethical Committee of National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, (17-048/1303).

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Perspectives on geriatric oncology research presented at the 2019 International Society of Geriatric Oncology Annual Meeting: Young International Society of Geriatric Oncology report

Grant

Haase

Marinho

2020

Journal of Geriatric Oncology

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Optimizing Chemotherapy for Frail and/or Elderly Patients With Advanced Gastroesophageal Cancer (Agoac): The Go2 Phase Iii Trial

Cited by 3 publications

References 0 publications

Management of chemotherapy dose intensity for metastatic colorectal cancer (Review)

Management of chemotherapy dose intensity for metastatic colorectal cancer (Review)

Biweekly Oxaliplatin Plus S1 (SOX) As First Line Therapy For Advanced Or Metastatic Gastric Or Gastroesophageal Junction (G/GEJ) Caner In Chinese Elderly Patients: An Open-Label, Single-Arm, Phase 2 Study.

Perspectives on geriatric oncology research presented at the 2019 International Society of Geriatric Oncology Annual Meeting: Young International Society of Geriatric Oncology report

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