Alexander Rühle, Executive Senior Physician at Leipzig University Hospital, Research Associate at DKFZ German Cancer Research Center shared on LinkedIn:
“New publication in the European Journal of Cancer:
Older Adults With Resectable Gastric Cancer Undergoing Perioperative Chemotherapy or Preoperative Chemoradiotherapy Plus Perioperative Chemotherapy: A Secondary Analysis of the AGITG TOPGEAR Phase III Trial
Older adults make up a growing share of patients with gastric cancer, yet they remain underrepresented in randomized trials. There is conflicting data whether older adults with gastric cancer exhibit comparable outcomes to their younger counterparts. From a clinical perspective, there also remains uncertainty as to whether older patients should be treated with the same perioperative treatment regimens and dose intensities as younger adults
In this secondary analysis of the international phase III AGITG TOPGEAR phase III trial, we compared treatment adherence, toxicity, surgical outcomes, and survival between patients aged ≥70 and <70 years undergoing perioperative chemotherapy with or without preoperative chemoradiotherapy for resectable gastric or gastro-esophageal junction cancer.
Key findings:
- Older adults more often required chemotherapy dose reductions/delays and had higher rates of hematologic adverse events, particularly in the chemotherapy-alone arm
- Surgical feasibility, R0 resection rates, and postoperative complications were comparable across age groups
- Overall survival and progression-free survival were comparable between older and younger patients, with numerically favorable outcomes in older adults
Bottom line: Fit older adults with gastric cancer can achieve outcomes comparable to younger patients with multimodal therapy, but they need closer monitoring of hematologic adverse events and strong supportive care.
Grateful to my co-authors and the AGITG TOPGEAR investigators for this collaboration: Alina Krause, Rachel L. O’Connell, John Simes, Michael Michael, Mark Smithers, Rebecca KS Wong, Karin Haustermans, Nils Nicolay, Trevor Leong, Florian Lordick for the Australasian Gastro-Intestinal Trials Group, the National Health and Medical Research Council (NHMRC) Trials Centre, the Trans Tasman Radiation Oncology Group (TROG Cancer Research), the EORTC – European Organization for Research and Treatment of Cancer, and Canadian Cancer Trials Group.”
To which, Florian Lordick, Professor of Medicine at Leipzig University, Editor-in-Chief of ESMO Gastrointestinal Oncology, added:
“Thank you Trevor Leong and the wonderful Australian Gastrointestinal Trials Group Team for this collaboration.”
Title: Older Adults With Resectable Gastric Cancer Undergoing Perioperative Chemotherapy or Preoperative Chemoradiotherapy Plus Perioperative Chemotherapy: A Secondary Analysis of the AGITG TOPGEAR Phase III Trial
Authors։ Alexander Rühle, Alina Krause, Rachel L. O’Connell, John Simes, Michael Michael, Bernard Mark Smithers, Rebecca Wong, Karin Haustermans, Nils H. Nicolay, Trevor Leong, Florian Lordick.
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