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The effect of geriatric intervention in frail older patients receiving chemotherapy for colorectal cancer: a randomised trial (GERICO)

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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.

OriginalsprogEngelsk
TidsskriftBritish Journal of Cancer
Vol/bind124
Udgave nummer12
Sider (fra-til)1949–1958
Antal sider10
ISSN0007-0920
DOI
StatusUdgivet - jun. 2021

Bibliografisk note

Funding Information:
Funding information This work was supported by Aage and Johanne Louis-Hansen Foundation, Beckett Foundation, Danielsen Foundation, Danish Cancer Society, Doctor Sofus Carl Emil Friis and wife Olga Doris Friis Scholarship, Foundation for Clinical Cancer Research, Hede Nielsen Foundation and Velux Foundation. Grant numbers not applicable.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Cancer Research UK.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

ID: 66211140