Outcomes of older adults with advanced cancer who prefer quality of life versus prolonging survival

Limited data exist on the outcomes achieved by patients with cancer with different treatment outcome preferences. Secondary analysis of the GAP70+ cluster randomized trial in the US tested the hypothesis that among older adults with advanced cancer, those prioritizing survival versus quality of life (QoL) would live longer, while those prioritizing QoL would have fewer treatment-related adverse effects (TRAEs) and hospitalizations. The analysis included 706 patients, who were divided into 2 cohorts based on their reported preference for prioritizing extending survival versus maintaining QoL. Only 59 patients (8.4%) preferred extending survival over maintaining QoL, whereas 506 patients (71,7%) preferred maintaining QoL over extending survival. No significant differences were identified between the cohorts in treatment modifications, grade 3 to 5 TRAEs, hospitalizations, or survival. The authors conclude that the current oncology care delivery system may not be responsive to the preferences of older adults with advanced cancer.