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
Green Published, hybrid
|