Abstract 497P
Background
Humanity is aging rapidly, about 50% of all human malignancies develop in people over 65 years old. In 2020, the prevalence of colorectal cancer (CRC) in patients over 60 years was 16.3%, mortality – 15.1%. For effective chemotherapy in this group of patients, the correction of geriatric syndromes (CGS) is extremely relevant. The aim of the study is to increase the efficiency of the first-line chemotherapy in patients with metastatic CRC (mCRC) using CGS.
Methods
The study included data on 177 patients with mCRC who received first-line chemotherapy: 59 patients according to the “FOLFOX±Bev+CGS” scheme, and 118 patients according to the “FOLFOX±Bev without CGS” scheme. Among them 104 patients were older than 60 years (66.5 [60; 81]) and 73 patients were middle-aged (53.1 [45;59]). The CGS was carried out by a multidisciplinary team of the rehabilitation department. The frequency of occurrence of geriatric syndromes (GS), objective response (OR), clinically significant response (CSR: OR+stabilization), event-free survival (EFS), and the toxic profile of chemotherapy were studied.
Results
The most common GS were malnutrition syndrome (by the MNA scale < 23.5 points) in 56.1% of patients, chronic pain syndrome in 51.2%, low physical activity (up to 2-3 times a week) in 39.1%. During the CGS, the index of nutritional status increased to 25.9 points (absence of malnutrition) in 80.5% of patients; the degree of pain decreased to 35.2%, and the level of physical activity (daily exercise) increased in all 100% of patients. Grade 3 neutropenia in the group “FOLFOX±Bev without CGS” was 10.7% and 14.8% for elderly and middle-aged patients respectively, and was completely absent in the group of patients with CGS; CSR was better in the group “FOLFOX±Bev+CGS” – 87.8%; without CGS - 69% (p<0.05); the median of EFS was higher in the group with CGS regardless of age and treatment regimen - 9.9 (8.84-11.08) months, without CGS-7.2 (4.15-10.24) months, p< 0.05).
Conclusions
The CGS allows to improve not only the geriatric status and tolerability of chemotherapy, but also the direct results of treatment (CSR) and long-term results (EFS) in patients with mCRC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
T.Y. Semiglazova.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.