Factors affecting treatment resilience in patients with oesophago-gastric cancers undergoing palliative chemotherapy: a rapid review

Datta, Kiran, Byrne, Anthony and Holland-Hart, Daniella ORCID: https://orcid.org/0000-0002-1127-5152 2025. Factors affecting treatment resilience in patients with oesophago-gastric cancers undergoing palliative chemotherapy: a rapid review. Clinical Oncology , 103963. 10.1016/j.clon.2025.103963 Item availability restricted.

	PDF (Provisional file) - Accepted Post-Print Version Download (17kB)
	PDF - Accepted Post-Print Version Restricted to Repository staff only Download (1MB)

Abstract

Oesophago-gastric cancers are the fifth commonest in the UK. Most patients will present with advanced disease and are unsuitable for curative surgery, instead receiving palliative treatment to improve prognosis and symptom burden. Treatment resilience refers to the ability of patients to tolerate their anti-cancer treatment. Palliative chemotherapy can result in significant toxicity; almost 40% of patients are unable to complete their chemotherapy regimen, with this proportion rising significantly in older and frailer patients. Despite most cases occurring in patients over 70, older and frailer patients are often excluded from clinical trials, resulting in limited evidence to guide which patients are most likely to benefit from palliative chemotherapy. This review aimed to appraise evidence regarding treatment resilience in order to guide clinicians in identifying the most suitable candidates for palliative chemotherapy. It was conducted using modified systematic methods. Search results were limited to papers within the last 10 years. Pretreatment characteristics influencing treatment resilience were assessed, as measured by completion rates, dose reductions and toxicities. Of the 931 papers returned, 14 reports of 13 studies were included in this review. Factors assessed included age, performance status, frailty, lymphopenia and sarcopenia. Frailty and body composition appear potentially reliable indicators of chemotherapy toxicity. Poor performance status may be a possible indicator of treatment non-completion. There was no clear relationship between treatment resilience and age or lymphopenia. Although this review was unable to specify patient characteristics to reliably predict patient tolerance of palliative chemotherapy, potential factors were identified. Future research should focus on prospective investigation of these factors identified to support a precision medicine algorithmic approach by multidisciplinary teams to assessing treatment resilience. Age should not necessarily be a barrier to receiving chemotherapy. Decisions regarding palliative treatment may be guided by these factors as well as patient preference.

Item Type:	Article
Status:	In Press
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Start Date: 2025-10-24
Publisher:	Elsevier
ISSN:	0936-6555
Date of First Compliant Deposit:	3 November 2025
Date of Acceptance:	17 October 2025
Last Modified:	03 Nov 2025 17:00
URI:	https://orca.cardiff.ac.uk/id/eprint/182088

Actions (repository staff only)

Edit Item