{"id":5904,"date":"2020-04-30T11:45:59","date_gmt":"2020-04-30T10:45:59","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=5904"},"modified":"2021-03-22T09:56:55","modified_gmt":"2021-03-22T09:56:55","slug":"optimizing-chemotherapy-for-frail-and-or-elderly-patient-with-advanced-gastroesophageal-cancer-agoac-the-go2-phase-iii-trial-2019","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/04\/30\/optimizing-chemotherapy-for-frail-and-or-elderly-patient-with-advanced-gastroesophageal-cancer-agoac-the-go2-phase-iii-trial-2019\/","title":{"rendered":"Optimizing chemotherapy for frail and\/or elderly patient with advanced gastroesophageal cancer (AGOAC): the GO2 phase III trial (2019)"},"content":{"rendered":"

Type of publication:<\/strong>
\nConference abstract<\/p>\n

Author(s):<\/strong>
\nSwinson D.E.; Hall P.; Seymour M.; Lord S.; Marshall H.; Ruddock S.; Cairns D.; Waters J.; Wadsley J.; Falk S.; Roy R.; Joseph M.; Nicoll J.; Vellios Kamposioras K.; Tillett T.; Cummins S.; Grumett S.; Stokes Z.; Waddell T.; *Chatterjee A.; Garcia A.; Allmark C.; Khan M.; Petty R.<\/p>\n

Citation:<\/strong>
\nJournal of Geriatric Oncology; Nov 2019; vol. 10 (no. 6), Supplement 1, S8<\/p>\n

Abstract:<\/strong>
\nIntroduction: aGOAC patients are frequently elderly and\/or frail.
\nObjective(s): (i) find the optimum dose of oxaliplatin capecitabine (OCap) for this population; (ii) explore the use of an objective geriatric assessment to individualize dose for maximum overall treatment utility (OTU), a composite of clinical benefit, tolerability, quality of life (QL) and patient value.
\nMethod(s): Patients with aGOAC were eligible if there was uncertainty of the appropriate dose of chemotherapy. Baseline assessment included global QL; symptoms; functional scales; comorbidity; frailty. Randomization was 1:1:1 to dose Level A (Ox 130 mg\/m2 d1, Cap 625 mg\/m2 bd d1-21, q21d), B (80% Level A) or C (60% Level A). At 9 weeks, patients were scored for OTU. Non-inferiority (vs A) was assessed using PFS, censored at 12 months, with upper boundary HR 1.34 (based on patients' and clinicians' discussions), needing 284 PFS events per two-way comparison. In a separate sub-study, when there was uncertainty regarding the use of chemotherapy, patients were randomized between level C and supportive care alone (SCA).
\nResults and Conclusion(s): 512 patients were randomized, 2014-2017, at 61 UK centers. Age, performance status and frailty were similar in all arms. Non-inferiority of PFS is confirmed for Level B vs A (HR 1.09, CI 0.89-1.32) and for Level C vs A (HR 1.10, CI 0.90-1.33). Level C patients had the least toxicity and best OTU outcomes. When analyzed by baseline age, frailty and PS no group was identified who benefit more from higher treatment doses. A further 46 patients were randomized between chemotherapy and SCA. A non-significant trend to improved survival was observed (HR=0.69, CI 0.32-1.48) and QL deteriorated less with chemotherapy. This is the largest RCT specifically investigating frail and\/or elderly aGOAC patients, and should guide future treatment. The lowest dose tested was non-inferior in terms of PFS, produced less toxicity and better overall treatment utility.<\/p>\n","protected":false},"excerpt":{"rendered":"

Type of publication: Conference abstract Author(s): Swinson D.E.; Hall P.; Seymour M.; Lord S.; Marshall H.; Ruddock S.; Cairns D.; Waters J.; Wadsley J.; Falk S.; Roy R.; Joseph M.; Nicoll J.; Vellios Kamposioras K.; Tillett T.; Cummins S.; Grumett…<\/span><\/p>\n

Read more Optimizing chemotherapy for frail and\/or elderly patient with advanced gastroesophageal cancer (AGOAC): the GO2 phase III trial (2019)<\/span> ›<\/span><\/a><\/div>\n

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