Reduced-Intensity Chemotherapy in Older Patients with Gastroesophageal Cancer Does Not Compromise Efficacy

Many practitioners routinely reduce chemotherapy dosing or intensity in older or frail patients, yet there are limited data from randomized controlled trials addressing treatment in these populations.

In the investigator-initiated, multicenter, phase 3 GO2 trial, patients with locally advanced or metastatic gastroesophageal cancer who were considered too old or frail for full-dose standard combination chemotherapy were assigned to one of two treatment paths: chemo-intensity or chemo–best supportive care (BSC). In the chemo-intensity path, patients were randomized to oxaliplatin at 130 mg/m² on day 1 of a 21-day cycle, or 80% of that dose, or 60% of that dose, plus capecitabine at 625 mg/m² twice daily on days 1 to 21. In the chemo-BSC path, …