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- Title
First-Line Biological Agents Plus Chemotherapy in Older Patients with Metastatic Colorectal Cancer: A Retrospective Pooled Analysis.
- Authors
García-Alfonso, Pilar; Díaz-Rubio, Eduardo; Abad, Albert; Carrato, Alfredo; Massutí, Bartomeu; Ortiz-Morales, María José; Manzano Mozo, José Luis; Muñoz, Andrés; Durán, Gema; Sastre, Javier; Safont, María José; Ferreiro, Reyes; Rivera, Fernando; González, Encarnación; Valladares-Ayerbes, Manuel; Grávalos, Cristina; Alonso-Orduña, Vicente; Viéitez, José María; Yubero, Alfonso; Aranda, Enrique
- Abstract
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.
- Subjects
DRUG efficacy; SAFETY; COLON tumors; CONFIDENCE intervals; RECTUM tumors; CANCER chemotherapy; AGE distribution; METASTASIS; ANTINEOPLASTIC agents; RETROSPECTIVE studies; MONOCLONAL antibodies; TREATMENT effectiveness; BIOTHERAPY; DESCRIPTIVE statistics; BEVACIZUMAB; OLD age
- Publication
Drugs & Aging, 2021, Vol 38, Issue 3, p219
- ISSN
1170-229X
- Publication type
Article
- DOI
10.1007/s40266-021-00834-w