512P External validity of the ARCAD nomogram in a real-life population of older patients with unresectable advanced colorectal cancer

Purpose Colorectal cancer predominantly occurs in the elderly, but approximately 5% of patients are 50 years old or younger. We sought to determine whether young age is prognostic, or whether it influences efficacy/toxicity of chemotherapy, in patients with advanced disease. Methods We analyzed individual data on 6,284 patients from nine phase III trials of advanced colorectal cancer (aCRC) that used fluorouracil-based single-agent and combination chemotherapy. End points included progression-free survival (PFS), overall survival (OS), response rate (RR), and grade 3 or worse adverse events. Stratified Cox and adjusted logistic-regression models were used to test for age effects and age-treatment interactions. Results A total of 793 patients (13%) were younger than 50 years old; 188 of these patients (3% of total patients) were younger than 40 years old. Grade 3 or worse nausea (10% v 7%; P = .01) was more common, and severe diarrhea (11% v 14%; P = .001) and neutropenia (23% v 26%; P < .001) were less common in young (younger than 50 years) than in older (older than 50 years) patients. Age was prognostic for PFS, with poorer outcomes occurring in those younger than 50 years (median, 6.0 v 7.5 months; hazard ratio, 1.10; P = .02), but it did not affect RR or OS. In the subset of monotherapy versus combination chemotherapy trials, the relative benefits of multiagent chemotherapy were similar for young and older patients. Results were comparable when utilizing an age cut point of 40 years. Conclusion Young age is modestly associated with poorer PFS but not OS or RR in treated patients with aCRC, and young patients have more nausea but less diarrhea and neutropenia with chemotherapy in general. Young versus older patients derive the same benefits from combination chemotherapy. Absent results of a clinical trial, standard combination chemotherapy approaches are appropriate for young patients with aCRC.

Download Full-text

Efficacy and toxicity results of FOLFIRI-Aflibercept in advanced colorectal cancer (CRCm) in “real life”, retrospective study. Prognostic factors and specific populations.

Annals of Oncology ◽

10.1093/annonc/mdx261.294 ◽

2017 ◽

Vol 28 ◽

pp. iii103 ◽

Cited By ~ 1

Author(s):

Ana Fernandez Montes ◽

López Carlos López ◽

Alberto Carmona ◽

David Paez ◽

María Lopez Muñoz Ana ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Retrospective Study ◽

Advanced Colorectal Cancer ◽

Real Life

Download Full-text

Comorbidities (CM) and potential impact in outcomes of advanced colorectal cancer patients (ACC) in Argentina: EVIREPRO real life program - Trial in progress

Annals of Oncology ◽

10.1093/annonc/mdy151.292 ◽

2018 ◽

Vol 29 ◽

pp. v82-v83

Author(s):

A. Schmilovich ◽

F. Ramello ◽

M. Malicki ◽

N. Colombo Berra ◽

S. Rojo ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Advanced Colorectal Cancer ◽

Real Life ◽

Potential Impact ◽

Colorectal Cancer Patients

Download Full-text

Angiogenic inhibitors for older patients with advanced colorectal cancer: Does the age hold the stage?

World Journal of Gastroenterology ◽

10.3748/wjg.v19.i14.2131 ◽

2013 ◽

Vol 19 (14) ◽

pp. 2131 ◽

Cited By ~ 4

Author(s):

Giuseppe Aprile

Keyword(s):

Colorectal Cancer ◽

Older Patients ◽

Advanced Colorectal Cancer ◽

Angiogenic Inhibitors

Download Full-text

Analysis of first-line treatment in older patients with metastasic colorectal cancer

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220984229 ◽

2021 ◽

pp. 107815522098422

Author(s):

Arantxa Magallón Martínez ◽

Maria J Agustín Ferrández ◽

Andrea Pinilla Rello ◽

Vicente Gimeno-Ballester ◽

Angel Escolano Pueyo ◽

...

Keyword(s):

Colorectal Cancer ◽

Clinical Trials ◽

Older Patients ◽

Adult Population ◽

Real Life ◽

Line Treatment ◽

First Line ◽

Palmoplantar Erythrodysesthesia ◽

Dose Reductions ◽

First Line Treatment

Objective The purpose of this study was to analyse the effectiveness and safety of first-line treatment of metastatic colorectal cancer (CRCm) in older patients treated in a tertiary hospital. Material and methods This was an observational and retrospective study, including patients aged 75 years or older, with CRCm, who received chemotherapy treatment in 2017. The main variables studied were type of treatment, Progression-Free Survival (PFS), Overall Survival (OS), dose reductions, and treatment delays due to adverse events. Results A total of 59 patients (71.2% men) with a median age of 76 years were enrolled in this study. About 70% presented colon cancer, with the left colon being the most frequent location. They were treated with 9 different schemes, in most cases using polychemotherapy and biological agents. The median PFS and OS was 12 and 30 months, respectively. A total of 23/59 of patients started treatment at doses lower than recommended in the clinical practice guidelines. In terms of safety, 34/59 of patients had at least one dose reduction, and 30/59 suffered one treatment delay. The most frequent adverse reactions were asthenia, peripheral neuropathy, diarrhoea, and palmoplantar erythrodysesthesia. Conclusion Our patients presented baseline clinical characteristics similar to the general adult population, with no tumour characteristics associated with advanced age. The efficacy and toxicity were similar to those in the clinical trials, although our patients had more dose reductions. Considering the heterogeneity of patients and in the absence of clinical trials in the older population, real-life studies can be very useful.

Download Full-text