The effect of geriatric intervention in frail older patients receiving chemotherapy for colorectal cancer: a randomised trial (GERICO)
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Published:2021-04-07
Issue:12
Volume:124
Page:1949-1958
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ISSN:0007-0920
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Container-title:British Journal of Cancer
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language:en
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Short-container-title:Br J Cancer
Author:
Lund Cecilia MargaretaORCID, Vistisen Kirsten Kjeldgaard, Olsen Anne Pries, Bardal Pernille, Schultz Martin, Dolin Troels Gammeltoft, Rønholt Finn, Johansen Julia Sidenius, Nielsen Dorte Lisbeth
Abstract
Abstract
Background
Older patients with colorectal cancer (CRC) experience chemotherapy dose reductions or discontinuation. Comprehensive geriatric assessment (CGA) predicts survival and chemotherapy completion in patients with cancer, but the benefit of geriatric interventions remains unexplored.
Methods
The GERICO study is a randomised Phase 3 trial including patients ≥70 years receiving adjuvant or first-line palliative chemotherapy for CRC. Vulnerable patients (G8 questionnaire ≤14 points) were randomised 1:1 to CGA-based interventions or standard care, along with guideline-based chemotherapy. The primary outcome was chemotherapy completion without dose reductions or delays. Secondary outcomes were toxicity, survival and quality of life (QoL).
Results
Of 142 patients, 58% received adjuvant and 42% received first-line palliative chemotherapy. Interventions included medication changes (62%), nutritional therapy (51%) and physiotherapy (39%). More interventional patients completed scheduled chemotherapy compared with controls (45% vs. 28%, P = 0.0366). Severe toxicity occurred in 39% of controls and 28% of interventional patients (P = 0.156). QoL improved in interventional patients compared with controls with the decreased burden of illness (P = 0.048) and improved mobility (P = 0.008).
Conclusion
Geriatric interventions compared with standard care increased the number of older, vulnerable patients with CRC completing adjuvant chemotherapy, and may improve the burden of illness and mobility.
Trial registration
ClinicalTrials.gov ID: NCT 02748811.
Funder
Kræftens Bekæmpelse Aage og Johanne Louis-Hansens Fond Familien Hede Nielsens Fond Beckett-Fonden Aase og Ejnar Danielsens Fond Velux Fonden Læge Sofus Emil Friis Scholarship, Denmark Foundation for clinical cancer research, Denmark
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology
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