Older adults with advanced cancer often struggle to tolerate cytotoxic chemotherapy due to age-related conditions, leading oncologists to modify primary treatment plans during the first chemotherapy cycle. Researchers of this study aimed to examine the association between primary treatment modification and treatment tolerability in older adults starting new palliative chemotherapy regimens. Conducted as a secondary analysis of the GAP70+ trial, the cohort study included patients aged 70 years or older with incurable cancer and one or more geriatric assessment impairments. Data from 609 patients, analyzed in November 2022, compared standard-of-care chemotherapy regimens with primary treatment modifications, such as dose reductions or schedule changes.

The results indicated that nearly half (46.1%) of the patients received a modified treatment regimen. These modifications were associated with a reduced risk of severe toxic effects (relative risk [RR], 0.85) and functional decline (RR, 0.80). Additionally, patients with modified regimens had 32% lower odds of experiencing a composite adverse outcome, which included toxic effects, functional decline, and six-month overall survival (odds ratio, 0.68). The study concludes that primary treatment modifications can improve chemotherapy tolerability in older adults with advanced cancer.

Reference: Mohamed MR, Rich DQ, Seplaki C, et al. Primary Treatment Modification and Treatment Tolerability Among Older Chemotherapy Recipients With Advanced Cancer. JAMA Netw Open. 2024;7(2):e2356106. doi: 10.1001/jamanetworkopen.2023.56106.