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Frail older patients are often given full doses and then have them cut after bad side effects, or are given nothing. Trials should test starting at a lower dose from the beginning.
The GO2 trial in frail patients with advanced gastro-oesophageal cancer showed that the lowest of three chemotherapy dose levels gave non-inferior progression-free survival with better patient experience. This design, comparing upfront dose levels rather than escalating after toxicity, is rarely used elsewhere. A programme of GO2-style trials across common cancers would give evidence for the many frail patients for whom current guidelines offer only extrapolation.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Older and multimorbid patients are excluded and undertreated, Wrong doses, Oesophageal cancer.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Older and multimorbid patients are excluded and undertreated.
Shares Wrong doses, Gastric & gastro-oesophageal junction cancer, Cytotoxic chemotherapy, Colorectal cancer.
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Older and multimorbid patients are excluded and undertreated.
Shares Older and multimorbid patients are excluded and undertreated, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer.
Shares Older and multimorbid patients are excluded and undertreated, Trial design, endpoints and cost.
Shares Older and multimorbid patients are excluded and undertreated, Trial design, endpoints and cost.
Shares Older and multimorbid patients are excluded and undertreated, Wrong doses.