ArticleCureus2026
Effectiveness of a Geriatric Assessment-Driven Intervention (GAIN) on Chemotherapy Toxicities in Elderly Cancer Patients.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
backgroundElderly patients with cancer are highly vulnerable to severe chemotherapy-related toxicities due to age-related physiological decline, multimorbidity, and frailty. Standard performance scales like the Eastern Cooperative Oncology Group (ECOG) are often insufficient for assessing this risk. The Cancer and Aging Research Group (CARG) score is a validated tool for predicting chemotherapy toxicity, while the Geriatric Assessment-Driven Intervention (GAIN) model provides a structured, multidisciplinary framework to mitigate these risks.
objectiveThis study aimed to evaluate the effectiveness of the GAIN model in reducing the incidence of severe (grade ≥3) chemotherapy-related toxicities in elderly cancer patients. Secondary objectives included assessing the impact of GAIN on treatment continuity, hospitalization rates, and emergency department visits.
methodsA prospective, randomized controlled interventional study was conducted over six months in the oncology department of Employees' State Insurance Corporation (ESIC) Medical College and Post Graduate Institute of Medical Sciences and Research (PGIMSR), a tertiary care hospital in Bengaluru, India. Seventy patients aged 60 years or older with solid tumors initiating chemotherapy were enrolled and allocated to either the GAIN arm (n=35) or the Standard of Care (SOC) arm (n=35). All patients underwent a baseline comprehensive geriatric assessment, and their CARG toxicity risk score was calculated. Patients in the GAIN arm received individualized interventions from a multidisciplinary team (MDT) based on identified vulnerabilities. The SOC arm received routine oncological care. The primary outcome was the incidence of grade ≥3 chemotherapy-related toxicities, graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0.
resultsThe incidence of grade ≥3 chemotherapy-related toxicities was significantly lower in the GAIN arm, with 17 of 35 patients (48.6%) experiencing severe toxicity compared to 26 of 35 patients (74.3%) in the SOC arm (p=0.027). Patients in the GAIN arm also had numerically fewer unplanned hospitalizations (14, 40% vs. 17, 48.6%), emergency department visits (14, 40.0% vs. 16, 45.7%), chemotherapy dose modifications (four, 11.4% vs. eight, 22.9%), and early treatment discontinuations (four, 11.4% vs. eight, 22.9%), though these differences were not statistically significant.
conclusionThe integration of a GAIN significantly reduces the incidence of severe chemotherapy-related toxicities in elderly cancer patients.
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