First-Line Biological Agents Plus Chemotherapy in Older Patients with Metastatic Colorectal Cancer: A Retrospective Pooled Analysis


Por: Garcia-Alfonso, P, Diaz-Rubio, E, Abad, A, Carrato, A, Massuti, B, Ortiz-Morales, MJ, Mozo, JLM, Munoz, A, Duran, G, Sastre, J, Safont, MJ, Ferreiro, R, Rivera, F, Gonzalez, E, Valladares-Ayerbes, M, Gravalos, C, Alonso-Orduna, V, Vieitez, JM, Yubero, A and Aranda, E

Publicada: 1 mar 2021 Ahead of Print: 1 feb 2021
Resumen:
Background Biologicals, in combination with chemotherapy, are recommended as first-line treatment of metastatic colorectal cancer (mCRC); however, evidence guiding the appropriate management of older patients with mCRC is limited. Objective This study was undertaken to compare the efficacy and safety outcomes in older versus younger patients with mCRC who received first-line biological therapy. Methods This retrospective analysis used pooled data from five trials undertaken by the Spanish Cooperative Group for the Treatment of Digestive Tumours. All were studies of adults with advanced CRC who received first-line treatment with chemotherapy plus bevacizumab, cetuximab or panitumumab, stratified by age (>= 65 vs. < 65 years). Endpoints included progression-free survival (PFS), overall survival (OS), overall response rate (ORR) and safety. Results In total, 999 patients from five studies were included in the analysis: 480 (48%) were aged >= 65 years, and 519 (52%) were aged < 65 years. Median PFS did not differ significantly between patients aged >= 65 and < 65 years (9.9 vs. 9.4 months; hazard ratio [HR] 1.01; 95% confidence interval [CI] 0.88-1.17). Median OS was significantly shorter in older than in younger patients (21.3 vs. 25.0 months; HR 1.21; 95% CI 1.04-1.41). There was no significant difference between older and younger patients in ORR (59 vs. 62%). Patients aged >= 65 years experienced significantly more treatment-related grade 3 or higher adverse events (61.67%) than did patients aged < 65 years (45.86%). Conclusions Biologicals plus chemotherapy is an effective first-line treatment option for selected patients aged >= 65 years with mCRC and has a manageable safety profile and efficacy comparable to that observed in younger patients.

Filiaciones:
Garcia-Alfonso, P:
 Hosp Gen Univ Gregorio Maranon, Inst Invest Sanit Gregorio Maranon, Serv Oncol, Madrid, Spain

Diaz-Rubio, E:
 Inst Invest Hosp Clin San Carlos IdISSC, Hosp Clin San Carlos, CIBERONC, Madrid, Spain

Abad, A:
 Hosp Badalona Germans Trias & Pujol, ICO, Badalona, Spain

 IOR Hosp Univ Dexeus, Barcelona, Spain

Carrato, A:
 Alcala Univ, Hosp Univ Ramon y Cajal, CIBERONC, IRYCIS, Madrid, Spain

Massuti, B:
 Hosp Gen Univ Alicante, Alicante, Spain

Ortiz-Morales, MJ:
 Univ Cordoba, Inst Salud Carlos 3, Reina Sofia Hosp, IMIBIC,CIBERONC, Cordoba, Spain

:
 Hosp Badalona Germans Trias & Pujol, ICO, Badalona, Spain

Munoz, A:
 Hosp Gen Univ Gregorio Maranon, Inst Invest Sanit Gregorio Maranon, Serv Oncol, Madrid, Spain

Duran, G:
 Hosp Univ Reg & Virgen Victoria, Malaga, Spain

Sastre, J:
 Inst Invest Hosp Clin San Carlos IdISSC, Hosp Clin San Carlos, CIBERONC, Madrid, Spain

Safont, MJ:
 Hosp Gen Univ Valencia, Valencia, Spain

Ferreiro, R:
 Alcala Univ, Hosp Univ Ramon y Cajal, CIBERONC, IRYCIS, Madrid, Spain

Rivera, F:
 Hosp Univ Marques Valdecilla, IDIVAL, Santander, Spain

Gonzalez, E:
 Hosp Virgen Nieves, Granada, Spain

Valladares-Ayerbes, M:
 Complejo Hosp Univ A Coruna, Inst Invest Biomed INIBIC, La Coruna, Spain

Gravalos, C:
 Hosp Univ, Madrid, Spain

Alonso-Orduna, V:
 Hosp Univ Miguel Servet, Inst Invest Sanit Aragon IISA, Zaragoza, Spain

Vieitez, JM:
 Hosp Univ Cent Asturias, Oviedo, Spain

Yubero, A:
 Hosp Clin Univ Lozano Blesa, Zaragoza, Spain

Aranda, E:
 Univ Cordoba, Inst Salud Carlos 3, Reina Sofia Hosp, IMIBIC,CIBERONC, Cordoba, Spain
ISSN: 1170229X





DRUGS & AGING
Editorial
Adis International Ltd., 5 THE WAREHOUSE WAY, NORTHCOTE 0627, AUCKLAND, NEW ZEALAND, Reino Unido
Tipo de documento: Article
Volumen: 38 Número: 3
Páginas: 219-231
WOS Id: 000620103600001
ID de PubMed: 33615402
imagen Green Published, hybrid

MÉTRICAS