Optimizing Chemotherapy for Frail and Elderly Patients With Advanced Gastroesophageal Cancer

Optimizing Chemotherapy for Frail and Elderly Patients With Advanced Gastroesophageal Cancer


>>OK, so we’re talking about
gastroesophageal cancer and a study that ASCO has chosen to highlight. Why are you interested in this study?>>I love this study. A perennial problem in cancer clinical
trials is that the people we include in our trials are the fit,
healthy triathlete cancer patients, and we leave out the large
percentage of patients who by the age of 75 are a little bit frail and have
accumulated a few medical problems. And that leaves it impossible for us to
figure out whether treatments that work in healthy 60-year-olds are going to also work
in 75-year-olds with a few medical problems. The other chronic problem in oncology
is that we love to do more of studies. We love to add additional ingredients
to our chemotherapy regiments. What these investigators from
the University of Edinburgh in the United Kingdom did is
they asked a less of question. They compared three different chemotherapy
regimens for treating gastroesophageal cancer. Sort if in a three bears model of Baby Bear,
Mama Bear, Papa Bear the high dose regimen, the medium dose regiment
and the low dose regimen. But in this case the high dose
regimen is standard of care. What they showed is that in this three arm
randomized study of nearly 600 patients that outcomes for patients treated with
the low dose regimen were very comparable. Not only did they look at overall
survival, disease-free survival, they looked at tolerability and a novel-metric
that they call overall treatment utility, which really incorporates patients’ own
experiences being on the treatment as well as side effects and how long they lived. And it really showed in a non-inferiority design that the lower dose was non-inferior
to the standard dose.

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