Patterns of Use, Safety, and Effectiveness of Targeted Therapies in First-Line Treatment of Metastatic Colorectal Cancer According to Age: The STROMBOLI Cohort Study.

Abstract:

BACKGROUND:Metastatic colorectal cancer (mCRC) is increasingly treated using targeted therapies. Their real-life evaluation is insufficient, especially in elderly and frail patients. The aim was to describe use, safety, and effectiveness of targeted therapies in first-line mCRC treatment according to age. PATIENTS AND METHODS:Two field cohorts of patients initiating bevacizumab or cetuximab for first-line mCRC were pooled. Patients characteristics, use, and safety were compared between younger and elderly patients (<75 vs. ≥75 years). Two-year overall survival (OS) and progression-free survival (PFS) were estimated in both age groups using the Kaplan-Meier method adjusted on factors associated with death or progression identified with Cox multivariate modeling. RESULTS:Eight hundred patients (n = 411, 51.4% bevacizumab) were included: 498 (62.3%) male, median age 64 years, 118 (14.8%) Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2. Elderly patients (n = 126, 15.8%) were more often treated with 5-fluorouracil alone than younger. Severe adverse events were equivalent across age groups. ECOG-PS ≥1, abnormal hemoglobin, and abnormal alkaline phosphatases were associated with a higher risk of death; OS adjusted on these factors was similar between elderly and younger patients. ECOG-PS ≥1, lung metastases, abnormal hemoglobin, and abnormal creatinine clearance were associated with a higher risk of progression or death; PFS adjusted on these factors was similar across groups. CONCLUSION:Despite treatment adaptations, elderly patients could benefit from targeted therapies as younger without safety warning.

journal_name

Clin Colorectal Cancer

authors

Gouverneur A,Coutureau J,Jové J,Rouyer M,Grelaud A,Duc S,Gérard S,Smith D,Ravaud A,Droz C,Bernard MA,Lassalle R,Forrier-Réglat A,Noize P,ETNA study group and the EREBUS study group.

doi

10.1016/j.clcc.2018.11.005

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

e150-e162

issue

1

eissn

1533-0028

issn

1938-0674

pii

S1533-0028(18)30247-0

journal_volume

18

pub_type

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