565P - Real-world data of early-onset colon cancer (early-onset CC) from the AIO colopredict plus (CPP) registry: Clinical and molecular characteristics, treatment and outcome

Background

The incidence of early-onset colon cancer (early-onset CC, age <50 years (yrs)) is rising with limited data on its clinical and molecular characteristics. We analyzed a real-world cohort of the AIO ColoPredict Plus (CPP) Registry.

Methods

CPP collects data and tissue from patients (pts) with CC UICC stage I-III. Clinical and molecular characteristics were assessed comparing pts <50yrs with pts 50+ using student’s Test and Fishers exact test. Disease-free survival (DFS) rate at 3 yrs was reported. Comorbidity was assessed by Charlson comorbidity index (CCI). Median follow-up was 28.1 months.

Results

Out of 9215 pts 479 (5%) had early-onset CC (median age 44 yrs (22-49) vs. 72 yrs (50-100) in late-onset CC). There were no significant differences regarding sex or BMI. Younger pts had less comorbidities (CCI 0: 91%) than older pts. (CCI 0: 60%, p <0.001). Interestingly, younger patients had larger tumors (p=0.045), more often lymph node metastases (p=0.002) and thus higher UICC stages (p<0,001). Tumor localization was predominantly left-sided in early- (53%) and right-sided in late-onset CC (61%, p<0,001). Younger pts more often received adjuvant chemotherapy (p<0,001) and more frequently oxaliplatin combinations (p<0,001). Mutational analysis was available in 5045 pts, 5% (264 pts) with early-onset CC. No significant difference in K- or N-RAS mutations or MSI were detected. The KRAS subtype p.G12C and BRAF mutations were significantly less prevalent in early-onset compared to late-onset CC (p=0,03 and p<0,01). Younger pts had a better 3 yrs DFS rate.

Conclusions

Pts with early-onset CC in our unique real-world cohort are more often UICC stage III with left primary tumors and better DFS. They also display distinct molecular features which should be considered when making treatment decisions.

Clinical trial identification

DRKS00004305.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Roche, BioNtech.

Disclosure

All authors have declared no conflicts of interest.