ArticleJCO oncology practice2026
Treatment Tolerability in Older Adults With Advanced Cancer Receiving Geriatric Assessment-Guided Versus Oncologist-Guided Primary Treatment Modification: Secondary Analysis of the GAP70+ Trial.
Article in JCO oncology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02054741 (A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer), which is not on this map. Not yet cited in PubMed.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Geriatric Assessment Intervention for Patients Aged 70 and Over Receiving Chemotherapy or Similar Agents for Advanced Cancer: Reducing Toxicity in Older Adults
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14 authors.
Funding
Abstract
purposePrimary treatment modification (PTM; changes in treatment dose or agents from standard guidelines) is common among older adults with advanced cancer because of aging-related vulnerabilities. Geriatric assessment evaluates aging-related factors to inform personalized treatment. We compared treatment tolerability between PTM guided by geriatric assessment-guided management (PTM-GAM) and PTM determined by usual oncologic care (PTM-UC).
methodsThis secondary analysis of the GAP70+ study (ClinicalTrials.gov identifier: NCT02054741; PI: Mohile) was restricted to patients age 70+ years with incurable solid tumors who initiated systemic therapy with a PTM (N=298). PTM-GAM (n = 169) was guided by GA results and management recommendations, whereas PTM-UC (n = 129) was based solely on oncologist evaluation. Tolerability outcomes within 3 months of treatment initiation included grade 3 to 5 toxicity, secondary dose reduction (any unplanned decrease in dose after treatment initiation), decline in activities of daily living (ADL), and unplanned hospitalization. Associations were evaluated using multivariable cluster-weighted generalized estimating equation models.
resultsThe mean age was 77 years, and GI cancers were most common (37%). Overall, 59% experienced ≥1 grade 3 to 5 toxicity. Compared with PTM-UC, PTM-GAM was associated with a lower risk of grade 3 to 5 toxicity (relative risk, 0.77 [95% CI, 0.65 to 0.91]). Secondary dose reductions occurred in 22% of patients, with lower risk in PTM-GAM (RR, 0.47 [95% CI, 0.30 to 0.72]). PTM-GAM was associated with a nonsignificant reduction in unplanned hospitalization (RR, 0.69 [95% CI, 0.45 to 1.03]). No difference was observed in ADL decline (RR, 1.04 [95% CI, 0.74 to 1.48]).
conclusionOlder adults with advanced cancer who received GA-guided PTM had a 23% lower risk of grade 3 to 5 toxicities and a 53% lower risk of secondary dose reduction compared with PTM based on usual oncologic care. These findings underscore the role of geriatric assessment in optimizing treatment decisions and improving tolerability.
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