Outcomes of Older Adults With Advanced Cancer Who Prefer Quality of Life vs Prolonging Survival

作者：Daniel R. Richardson, Ying Wang, Marie Flannery, Mostafa Mohamed, Allison Magnuson, Megan Wells, Rachael Tylock, Enrique Soto-Perez-de-Celis, Clark DuMontier, William Dale, R. Epstein, Jeffrey L. Berenberg, Nadia Ramdin, Supriya G. Mohile, Kah Poh Loh · 发表于：JAMA Oncology · 年份：2026 · DOI：10.1001/jamaoncol.2026.0072 · 被引用次数：6 · 研究领域：Frailty in Older Adults、Cancer survivorship and care、Economic and Financial Impacts of Cancer

Importance: Health care systems should strive to achieve outcomes that matter to patients. Limited data exist on the outcomes achieved by patients with cancer with different treatment outcome preferences. Objective: To describe treatment outcome preferences among older adults with advanced cancer and explore differences in outcomes between patients prioritizing survival vs quality of life (QoL), testing the hypothesis that patients prioritizing survival would live longer, while those prioritizing QoL would have fewer treatment-related adverse effects (TRAEs) and hospitalizations. Design, Setting, and Participants: This study was an exploratory secondary analysis of the GAP70+ cluster randomized clinical trial conducted at National Cancer Institute's Community Oncology Research Program centers. Older adults (≥70 years) with incurable solid tumors or lymphoma and 1 or more impaired geriatric assessment domain(s) who were starting a new systemic cancer treatment as part of the GAP70+ trial were eligible. The primary trial took place between July 29, 2014, and March 13, 2019. All secondary analyses were conducted between January 1, 2025, and May 30, 2025. Exposure: Patients were divided into 2 cohorts based on their reported preference for prioritizing extending survival vs maintaining QoL. Main Outcomes and Measures: Treatment outcome preferences, hospitalization, TRAEs, and survival at 6 months and 1 year. Results: A total of 706 patients were included in the analysis. The mean...