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Title: Outcomes of Older Patients (≥ 70 Years) Treated With Targeted Therapy in Metastatic Chemorefractory Colorectal Cancer: Retrospective Analysis of NCIC CTG CO.17 and CO.20.
Authors: Wells, J Connor;Tu, Dongsheng;Siu, Lillian L;Shapiro, Jeremy D;Jonker, Derek J;Karapetis, Christopher S;Simes, John;Liu, Geoffrey;Price, Timothy J;Tebbutt, Niall C;O'Callaghan, Chris J
Affiliation: Cabrini Health, Melbourne, Australia
Queen's School of Medicine, Kingston, Canada.
Canadian Cancer Trials Group, Kingston, Canada..
Austin Health, Heidelberg, Victoria, Australia
Queen Elizabeth Hospital and University of Adelaide, Adelaide, Australia
National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
Flinders Medical Centre and Flinders University, Adelaide, Australia
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada..
The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada..
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada..
Canadian Cancer Trials Group, Kingston, Canada..
Issue Date: 28-Nov-2018
EDate: 2018-11-28
Citation: Clinical colorectal cancer 2018; online first: 28 November
Abstract: The safety and efficacy of targeted therapy in older patients (≥ 70 years) with metastatic colorectal cancer is not well evaluated. Outcomes of older patients (including overall survival [OS], progression-free survival [PFS], toxicity, and quality of life [QoL]) were compared to young patients using data from 2 large previously reported clinical trials, CO.17 (cetuximab vs. best supportive care) and CO.20 (cetuximab plus placebo vs. cetuximab plus brivanib). Only patients with wild-type KRAS tumors were included. A total of 251 (26.3%) of 955 patients were ≥ 70 years old. No significant differences in OS, PFS, or grade 3/4 adverse events were observed between older and younger patients treated with cetuximab (or cetuximab with placebo) in either trial. Younger patients trended toward superior OS in both CO.17 (hazard ratio = 1.80; P = .16) and CO.20 (hazard ratio = 1.34; P = .07). QoL maintenance favored younger patients in CO.17 (3.6 vs. 5.7 months; P = .046) but no difference of QoL maintenance was observed in the larger CO.20 trial (1.7 vs. 1.8 months; P = .64). Combination therapy of cetuximab and brivanib was significantly more toxic in older adults (87% vs. 77%; P = .03). OS, PFS, and toxicities were similar between older and younger patients with wild-type KRAS metastatic colorectal cancer when treated with cetuximab. Both age groups likely experience similar QoL maintenance with cetuximab. Dual targeted therapy was significantly more toxic in older patients.
DOI: 10.1016/j.clcc.2018.11.006
PubMed URL: 30595557
Type: Journal Article
Subjects: Cetuximab
Quality of life
Appears in Collections:Journal articles

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