Mature tree symbolizes older adults standing strong against a storm (cancer treatment) with hopeful light.

Gastric Cancer in Older Adults: Balancing Treatment and Quality of Life

Avery Sinclair in Health & Wellness November 2025 • 4 min read.

"A real-world look at second-line treatment efficacy and toxicity in older versus younger patients reveals key insights for managing advanced gastric cancer."

Gastric cancer, a significant global health concern, disproportionately affects older adults. While its incidence rises with age, older patients are often underrepresented in clinical trials, making it challenging to determine the most effective and safe treatment strategies for this population.

A recent multi-center study published in the Journal of Geriatric Oncology sheds light on this critical issue. Researchers compared the experiences of older (70+) and younger patients with advanced gastric cancer who received at least two lines of chemotherapy. The goal was to identify differences in treatment efficacy, toxicity, and overall survival to inform more tailored treatment approaches for older adults.

This article delves into the study's findings, highlighting key differences in tumor characteristics, treatment choices, and outcomes. It offers valuable insights for healthcare professionals and individuals seeking a better understanding of how age influences the management of advanced gastric cancer and how to optimize treatment strategies while prioritizing quality of life.

Key Findings: How Age Impacts Gastric Cancer Treatment

Mature tree symbolizes older adults standing strong against a storm (cancer treatment) with hopeful light.

The study, led by Valentina Fanotto and colleagues, analyzed data from 868 patients with advanced gastric cancer across multiple Italian oncology centers. Of these, 276 patients (31.8%) were 70 years or older at the start of second-line chemotherapy. The researchers meticulously compared various factors between the older and younger groups, including:

Here are some of the core comparison factors:

Tumor characteristics (histology, differentiation, stage)
Treatment regimens (single-agent vs. combination chemotherapy)
Survival outcomes (progression-free survival (PFS) and overall survival (OS))
Treatment-related toxicities and adverse events

While the older group demonstrated some differences in tumor biology, the study's most significant takeaway was that age alone did not significantly impact survival outcomes. Despite often receiving less intensive treatment (single-agent chemotherapy), older patients achieved similar PFS and OS compared to their younger counterparts. Let's dive into the specifics:

Personalized Care: The Future of Gastric Cancer Treatment in Older Adults

This study reinforces the importance of individualized treatment plans that consider not just age but also overall health status, tumor characteristics, and patient preferences. While further research is needed, this study provides valuable insights for optimizing treatment strategies and improving the quality of life for older adults facing advanced gastric cancer. By challenging preconceived notions about age and treatment intensity, this research paves the way for more personalized and effective care for all patients.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jgo.2018.11.009, Alternate LINK

Title: Second-Line Treatment Efficacy And Toxicity In Older Vs. Non-Older Patients With Advanced Gastric Cancer: A Multicentre Real-World Study

Subject: Geriatrics and Gerontology

Journal: Journal of Geriatric Oncology

Publisher: Elsevier BV

Authors: Valentina Fanotto, Lorenzo Fornaro, Roberto Bordonaro, Gerardo Rosati, Lorenza Rimassa, Samantha Di Donato, Daniele Santini, Gianluca Tomasello, Francesco Leone, Nicola Silvestris, Silvia Stragliotto, Mario Scartozzi, Riccardo Giampieri, Federico Nichetti, Lorenzo Antonuzzo, Saverio Cinieri, Antonio Avallone, Antonio Pellegrino, Davide Melisi, Enrico Vasile, Lorenzo Gerratana, Giuseppe Aprile

Published: 2019-07-01

Everything You Need To Know

What are the key considerations when treating older adults with advanced gastric cancer?

When treating older adults with advanced gastric cancer, key considerations involve balancing treatment efficacy with quality of life. Older patients are often underrepresented in clinical trials, so treatment strategies should be tailored based on individual health status, tumor characteristics, and patient preferences. A recent study highlighted that age alone doesn't significantly impact survival outcomes, suggesting that less intensive treatments like single-agent chemotherapy can be as effective as combination chemotherapy while potentially reducing toxicity. Therefore, personalized care is crucial.

How did the Journal of Geriatric Oncology study differentiate treatment approaches between older and younger patients with advanced gastric cancer?

The *Journal of Geriatric Oncology* study, led by Valentina Fanotto and colleagues, compared older (70+) and younger patients with advanced gastric cancer receiving at least two lines of chemotherapy. The study meticulously analyzed differences in tumor characteristics (histology, differentiation, stage), treatment regimens (single-agent vs. combination chemotherapy), survival outcomes (progression-free survival (PFS) and overall survival (OS)), and treatment-related toxicities. This comparative approach aimed to identify how age influences treatment outcomes and to inform more tailored treatment strategies for older adults.

What specific survival outcomes were analyzed in the study, and what were the key findings regarding age?

The study analyzed progression-free survival (PFS) and overall survival (OS) as key survival outcomes. The main finding was that age alone did not significantly impact these survival outcomes. Older patients, despite often receiving less intensive treatment such as single-agent chemotherapy, achieved similar PFS and OS compared to younger patients. This suggests that treatment intensity can be adjusted based on individual factors rather than solely on age.

What implications does the finding that 'age alone did not significantly impact survival outcomes' have on gastric cancer treatment strategies?

The finding that age alone did not significantly impact survival outcomes challenges the assumption that older patients always require less intensive treatment. It suggests that healthcare professionals should focus on a personalized approach, considering factors such as overall health status, tumor characteristics, and patient preferences. This can lead to more tailored treatment plans that balance efficacy with quality of life, potentially improving outcomes and reducing unnecessary toxicities in older adults with advanced gastric cancer. Furthermore, it encourages the exploration of less intensive yet effective treatment options, like single-agent chemotherapy, when appropriate.

How does the concept of 'personalized care' apply to older adults with advanced gastric cancer, and what are its potential benefits?

Personalized care for older adults with advanced gastric cancer involves tailoring treatment plans to individual needs, considering factors beyond just age. This includes evaluating overall health status, tumor characteristics (histology, differentiation, stage), and patient preferences. The benefits of personalized care include optimizing treatment efficacy while minimizing toxicities, which can significantly improve quality of life. For example, if an older patient has significant comorbidities, a less intensive treatment like single-agent chemotherapy might be preferred to reduce the risk of adverse events without compromising survival outcomes. This approach ensures that treatment decisions are aligned with the patient's specific needs and goals.