Abstract 92P
Background
Colorectal cancer (CRC) is the third most common cancer worldwide and a leading cause of cancer-related death. About half of CRC patients are geriatrics; however, they are underrepresented in clinical trials. In this study, we concentrate on their differential clinical features and mutational landscape.
Methods
CRC patients were identified in the GENIE Consortium Cohort (v15.1) and were divided regards to the age at which sequencing was reported to >70 and ≤70ys. We examined the different clinical and mutational landscape from cBioPortal focusing on the clinical actionability mutations identified in CRC using the OncoKB.
Results
18,327 samples for 17,426 patients were identified, 26.53 % (n=3827) and 73.47% (n=14423) were >70 and ≤70 respectively. Females were significantly higher proportion in >70 than ≤70ys; They accounted for 47.86% vs 44.95% respectively (P 6.853e-4, q 8.810e-4). Colon adenocarcinoma accounted for 62.05% vs 56.79% and rectal adenocarcinoma was 14.4% vs 18.7% in >70 and ≤70ys respectively (p < 10-10, q < 10-10). The median mutation-count was significantly higher in >70 than ≤70ys with 8 mutations (range 1- 26.5) versus 7 mutations (range 1-21.5) respectively (p < 10-10, q < 10-10). Significantly different incidence of genomic alterations was observed in >70 vs ≤70ys; 250 mutated genes were significantly higher in incidence with patients >70 and only 5 genes were significantly higher in patients ≤70ys (APC, TP53, RECQL4, SYNE1, and ARFRP1). Regarding the genes harboring clinically actionable alterations according to the OncoKB, no significant differences were observed in KRAS, NRAS, CDKN2A, CDK12, NTRK2, FGFR2, and FGFR. On the contrary, BRAF, ARID1A, PTEN, MTOR, NF1, NTRK3, NTRK1, FGFR3 and MET were significantly higher in >70 than ≤70ys. For instance, BRAF was 20.54% (n=717) vs 9.16% (n=1253) in >70 vs ≤70ys (p< 10-10, q< 10-10).
Conclusions
Elderly patients are sub-represented compared to younger adults. They Carry different clinical features and genomic mutational landscapes that influence treatment choices. These differences may be related to tumor sidedness percentages and further studies on geriatrics patients are crucial.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.