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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.
Austin Authors: Wells, J Connor;Tu, Dongsheng;Siu, Lillian L;Shapiro, Jeremy D;Jonker, Derek J;Karapetis, Christos;Simes, John;Liu, Geoffrey;Price, Timothy J;Tebbutt, Niall C ;O'Callaghan, Chris J
Affiliation: Austin Health, Heidelberg, Victoria, Australia
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
Canadian Cancer Trials Group, Kingston, Canada
Queen's School of Medicine, Kingston, Canada
Queen Elizabeth Hospital and University of Adelaide, Adelaide, Australia
The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
Cabrini Health, Melbourne, Australia
Flinders Medical Centre and Flinders University, Adelaide, Australia
National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia
Issue Date: Mar-2019 2018-11-28
Publication information: Clinical colorectal cancer 2019; 18(1): e140-e149
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
Journal: Clinical colorectal cancer
PubMed URL: 30595557
Type: Journal Article
Subjects: Cetuximab
Quality of life
Appears in Collections:Journal articles

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