Chemotherapy Efficacy and Tolerability in Metastatic Gastric Cancer Patients Aged 75 Years and Older

Abstract

A lthough the incidence of gastric cancer has decreased with the preservation of food under more suitable conditions, the incidence is still increasing in the elderly population. Gastric cancer is the 5 th most frequently common cancer worldwide and the 3 rd most leading cause of malignancy-related deaths. [1][2][3][4][5] Despite the development of surgical, targeted therapies and combined chemotherapy treatments, 5-year overall survival (OS) rates are less than 30%. [3,6] Most patients with gastric cancer are diagnosed at an advanced stage. [3] The average age of diagnosis is 71 and the average age of death is 74. [4,5] More than half of patients have no chance of resection at the time of diagnosis. [7] There are many studies in which multimodal treatment is recommended in the treatment of non-metastatic gastric cancer. In multimodal treatment, preoperative neoadjuvant treatment, followed by surgical treatment and then adjuvant treatment is recommended. [8][9][10] Treatment for metastatic gastric cancer is palliative. Chemotherapy has favorable OS than best supportive care (BSC) in metastatic gastric cancer. [11,12] In a meta-analysis comparing combina-Objectives: More than half of gastric cancer patients have no chance of resection at the time of diagnosis. In gastric cancer, which has increased frequency with age, chemotherapy efficacy and tolerability in metastatic gastric cancer aged 75 and over have been investigated due to the fact that the elderly patient population is not sufficiently involved in the studies. Methods: In our study, the clinical and demographic characteristics of patients, treatment regimens and responses, prognostic factors, grad 3-4 toxicity, progression-free survival (PFS) and overall survival (OS) were examined. Results: In the study involving 118 patients, PFS was 5.8 months and OS was 8.4 months. A disease control rate of 38.1% was achieved with chemotherapy. Conclusion:Since the OS in this study was 10.5 months in patients with ECOG PS 0-1, 13.8 months in patients who received two lines or more, and the frequency of side effects was acceptable, we believe that this patient population should not be left untreated. Since there are acceptable survival values even with single-agent therapies, monotherapy can be recommended for patients with poor ECOG PS and combination therapies can be recommended for patients with good PS without comorbidities.