600P - Treatment (T) of metastatic colorectal cancer (mCRC) patients (pts) ≥75 years (y) old in clinical practice: A multicenter analysis

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Geriatric Oncology
Colon Cancer
Rectal Cancer
Presenter Roberta Grande
Citation Annals of Oncology (2014) 25 (suppl_4): iv167-iv209. 10.1093/annonc/mdu333
Authors R. Grande1, I. Pavese2, C. Natoli3, F. Ciancola4, D. Gemma5, A. Pellegrino2, C. Garufi6, L. Di Lauro7, D.C. Corsi8, D. Signorelli8, I. Sperduti9, G. Cortese3, E. Risi10, F. Morano11, D. Sergi7, C. Signorelli12, E.M. Ruggeri13, G. Zampa14, M. Russano15, T. Gamucci1
  • 1Medical Oncology Unit, ASL Frosinone, 03100 - Frosinone/IT
  • 2Department Of Oncology, San Pietro Fatebenefratelli Research Institute, IT-00189 - Roma/IT
  • 3Department Of Experimental And Clinical Sciences, University "G. d'Annunzio", Chieti/IT
  • 4Medical Oncology Unit, Sapienza, Policlinico Umberto I, Frosinone/IT
  • 5Medical Oncology Unit, ASL Frosinone, Frosinone/IT
  • 6Medical Oncology, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 7Division Of Medical Oncology B, Regina Elena National Cancer Institute, Rome/IT
  • 8Oncologia Medica, Ospedale San Giovanni Calibita - Fatebenefratelli, IT-00186 - Roma/IT
  • 9Biostatistics, Regina Elena National Cancer Institute, 00144 - Roma/IT
  • 10Dipartimento Di Medicina Sperimentale, Policlinico Umberto I, 00161 - Roma/IT
  • 11Oncologia B, Policlinico Umberto I, IT-00161 - Roma/IT
  • 12Medical Oncology Unit, ASL VITERBO, Viterbo/IT
  • 13Divisione Di Oncologia, Ospedale Belcolle, ASL di Viterbo Oncology Unit, 01100 - Viterbo/IT
  • 14Medical Oncology Unit, ASL RMA, Rome/IT
  • 15Medical Oncology, University Campus Bio-Medico, rome/IT

Abstract

Aim

CRC pts have a median age of incidence > 65y although they are largely under-represented in phase III trials. This large population contains pts unfit for T, those suitable for monotherapy or for doublets and the impact of chemotherapy (CHT) outside clinical trial is unclear. Aim of the study was to retrospectively analyse T of elderly mCRC pts.

Methods

Kaplan-Meir method was used for OS, the log-rank or Tarone-Ware test for diferences between subgroups, Cox's proportional hazard model to assess the impact of known prognostic factors and T.

Results

751 pts with mCRC observed from January 2000 to January 2013 were collected. Median age was 79y (75-93); < 80y 58.1%, 80-84y 32.1%, ≥84y 9.2%; M/F 61/39%, ECOG PS:0-1/2-3 85/15%, colon/rectum 74/26%; multiple metastatic sites 34%, only liver 41% of pts. KRAS status was studied in 35% of pts with 44% mutated (M); 20,5% of pts were untreated including surgery (33% of pts ≥80y). Comorbidities: cardiovascular 34%, diabetes 14%, hypertension 50%. Primary tumor was resected in 80.6%; surgery(S) of liver metastasis in 19% of pts (2.3% of pts ≥80y). 78 % of pts underwent CHT (target therapy for 25% of pts). Median follow up was 12 months (m) (range 1-124). Median OS was 17 m (CI 95%15-19); mOS in no-treated pts was 5 m (4-6); mOS of pts with at least one T was 20 m (18-22). In KRAS M group mOS was 19 m (15-23) while in KRAS wild type pts mOS was 25m (20-30). At multivariate analysis sex (female), age (<80y), PS (0-1), CHT, S of metastasis, S of primary tumor, and Site of metastasis (liver) were prognostic factors for OS.

Variables HR (CI95%) P value
Sex 1.21 (1.01-1.46) 0.04
Age 1.75 (1.45-2.12) <0.0001
ECOG PS 2.51 (1.94-3.25) <0.0001
CT 2.14 (1.68-2.73) <0.0001
S of metastasis 2.48 (1.88-3.29) <0.0001
S of primary tumor 1.66 (1.31-2.11) <0.0001
Site of metastasis 1.33 (1.09-1.63) 0.006

Conclusions

These data show that in clinical practice treatment of metastatic disease has a positive effect on elderly pts OS, confirmed at multivariate analysis. KRAS analysis deserve further evaluation. Update results will be presented.

Disclosure

All authors have declared no conflicts of interest.