Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis
Introduction: Gastric (GC) and gastro-esophageal cancer (GEC) are common neoplasms in the elderly. However, in clinical practice, the correct strategy for elderly patients who might benefit from chemotherapy (CT) is unknown. Prospective data are still poor. In this context, we performed a retrospect...
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| Format: | Article |
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MDPI AG
2022-09-01
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| Series: | Geriatrics |
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| Online Access: | https://www.mdpi.com/2308-3417/7/5/107 |
| _version_ | 1797473154462908416 |
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| author | Ina Valeria Zurlo Carmelo Pozzo Antonia Strippoli Samantha Mignogna Michele Basso Raffaella Vivolo Giovanni Trovato Michele Ciaburri Franco Morelli Emilio Bria Silvana Leo Giampaolo Tortora |
| author_facet | Ina Valeria Zurlo Carmelo Pozzo Antonia Strippoli Samantha Mignogna Michele Basso Raffaella Vivolo Giovanni Trovato Michele Ciaburri Franco Morelli Emilio Bria Silvana Leo Giampaolo Tortora |
| author_sort | Ina Valeria Zurlo |
| collection | DOAJ |
| description | Introduction: Gastric (GC) and gastro-esophageal cancer (GEC) are common neoplasms in the elderly. However, in clinical practice, the correct strategy for elderly patients who might benefit from chemotherapy (CT) is unknown. Prospective data are still poor. In this context, we performed a retrospective analysis of GC patients aged ≥75 years and treated at our institutions. Material and Methods: We retrospectively analyzed 90 patients with confirmed metastatic GC or GEC, treated with an upfront CT. Inclusion criteria were patients aged ≥75 years, PS 0–2, normal bone marrow/liver/renal function and no major comorbidities. All patients received a G8 score, and some patients with G8 ≤14 received a comprehensive geriatric assessment (CGA). The primary goal was to perform a safety evaluation based on the incidence of adverse events (AE), and the secondary goal was to determine the efficacy (PFS and OS). The chi-square test and the Kaplan–Meier method were used to estimate the outcomes. The statistical significance level was set at <i>p</i> < 0.05. Results: Toxicity rates were quite low: G1/G2 (51.1%) and G3/G4 (25.5%). No toxic deaths were reported. The median PFS was 6.21 months and the median OS 11 months. The G8 score and PS ECOG significantly influenced both PFS and OS. A statistically significant correlation among G8, weight loss, hypoalbuminemia and risk of G3/G4 adverse events was also found. Conclusion: Our research on selected elderly patients did not detect broad differences of efficacy and tolerability compared to a young population. Our study, although retrospective and small-sized, showed that G8 score might be an accurate tool to identify elderly GC/GEC patients who could be safely treated with CT, further recognizing patients who could receive a doublet CT and who may require a single agent chemotherapy or a baseline dose reduction. |
| first_indexed | 2024-03-09T20:10:54Z |
| format | Article |
| id | doaj.art-a7cf0d9ec07f4a28932123c7ce1215a2 |
| institution | Directory Open Access Journal |
| issn | 2308-3417 |
| language | English |
| last_indexed | 2024-03-09T20:10:54Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Geriatrics |
| spelling | doaj.art-a7cf0d9ec07f4a28932123c7ce1215a22023-11-24T00:18:17ZengMDPI AGGeriatrics2308-34172022-09-017510710.3390/geriatrics7050107Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World AnalysisIna Valeria Zurlo0Carmelo Pozzo1Antonia Strippoli2Samantha Mignogna3Michele Basso4Raffaella Vivolo5Giovanni Trovato6Michele Ciaburri7Franco Morelli8Emilio Bria9Silvana Leo10Giampaolo Tortora11Medical Oncology Unit, “Vito Fazzi” Hospital, 73100 Lecce, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, Gemelli Molise, 86100 Campobasso, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyGeriatric Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, Gemelli Molise, 86100 Campobasso, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyMedical Oncology Unit, “Vito Fazzi” Hospital, 73100 Lecce, ItalyMedical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, ItalyIntroduction: Gastric (GC) and gastro-esophageal cancer (GEC) are common neoplasms in the elderly. However, in clinical practice, the correct strategy for elderly patients who might benefit from chemotherapy (CT) is unknown. Prospective data are still poor. In this context, we performed a retrospective analysis of GC patients aged ≥75 years and treated at our institutions. Material and Methods: We retrospectively analyzed 90 patients with confirmed metastatic GC or GEC, treated with an upfront CT. Inclusion criteria were patients aged ≥75 years, PS 0–2, normal bone marrow/liver/renal function and no major comorbidities. All patients received a G8 score, and some patients with G8 ≤14 received a comprehensive geriatric assessment (CGA). The primary goal was to perform a safety evaluation based on the incidence of adverse events (AE), and the secondary goal was to determine the efficacy (PFS and OS). The chi-square test and the Kaplan–Meier method were used to estimate the outcomes. The statistical significance level was set at <i>p</i> < 0.05. Results: Toxicity rates were quite low: G1/G2 (51.1%) and G3/G4 (25.5%). No toxic deaths were reported. The median PFS was 6.21 months and the median OS 11 months. The G8 score and PS ECOG significantly influenced both PFS and OS. A statistically significant correlation among G8, weight loss, hypoalbuminemia and risk of G3/G4 adverse events was also found. Conclusion: Our research on selected elderly patients did not detect broad differences of efficacy and tolerability compared to a young population. Our study, although retrospective and small-sized, showed that G8 score might be an accurate tool to identify elderly GC/GEC patients who could be safely treated with CT, further recognizing patients who could receive a doublet CT and who may require a single agent chemotherapy or a baseline dose reduction.https://www.mdpi.com/2308-3417/7/5/107gastric cancerelderlytoxicityG8 scorecomprehensive geriatric assessment |
| spellingShingle | Ina Valeria Zurlo Carmelo Pozzo Antonia Strippoli Samantha Mignogna Michele Basso Raffaella Vivolo Giovanni Trovato Michele Ciaburri Franco Morelli Emilio Bria Silvana Leo Giampaolo Tortora Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis Geriatrics gastric cancer elderly toxicity G8 score comprehensive geriatric assessment |
| title | Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis |
| title_full | Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis |
| title_fullStr | Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis |
| title_full_unstemmed | Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis |
| title_short | Safety and Efficacy of a First-Line Chemotherapy Tailored by G8 Score in Elderly Metastatic or Locally Advanced Gastric and Gastro-Esophageal Cancer Patients: A Real-World Analysis |
| title_sort | safety and efficacy of a first line chemotherapy tailored by g8 score in elderly metastatic or locally advanced gastric and gastro esophageal cancer patients a real world analysis |
| topic | gastric cancer elderly toxicity G8 score comprehensive geriatric assessment |
| url | https://www.mdpi.com/2308-3417/7/5/107 |
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