Abstract 80P
Background
Despite a reduction of incidence and mortality from CRC in the elderly population, several studies have shown an increase in the incidence of early-onset CRC (EO-CRC). Clinical and prognostic data on this setting are limited and conflicting.The aim of our study was to evaluate the clinical, prognostic, and molecular profiles of metastatic EO-CRC patients in order to identify potentially relevant differences compared to a control group of late-onset CRC (LO-CRC).
Methods
We retrospectively collected data from 1272 metastatic colorectal cancers from 5 different Italian Institutions: 693 (54.5%) EO-CRC and 579 (45.5%) LO-CRC as control group. Patients had one or more metastatic sites, molecular profiling available, and underwent at least one line of treatment for metastatic disease. The main objective of the study was to the evaluate clinical outcome for the global population of EO-CRC patients in different clinical and molecular subgroups according to RAS and BRAFstatus and in comparison to patients included in the control group.
Results
In the EO-CRC group median age was 42.8 (20.0-50.9) and 66.7 (51.0-86.2) in the control group. M/F ratios were 1:1 and 2:1, respectively. In the overall population, mOS was 34.7 in EO-CRC pts vs 43.0 months (mo) (p < 0.0001) in the control group. In the RAS/BRAF mutated subgroup mOS in EO-CRC pts was 30.3 vs 34.0 mo in the control group (p = 0.0156). In RAS/BRAF wild-type subgroup mOS in EO-CRC pts was 43.0 vs 50.0 mo (p = 0.0290). Finally, in the BRAF V600E mut subgroup EO-CRC pts showed a 16 mo mOS vs 26 mo (p =0.04). In the overall population, mPFS was 11.0 in EO-CRC pts vs 14.0 mo (p < 0.0001) in the control group. Furthermore, the overall response rate (ORR) was 63% in EO-CRC and 67% in LO-CRC.
Conclusions
Findings from a large population of EO-CRC patients indicate a worse prognosis for pts with early-onset colorectal cancer compared to late-onset patients.Interestingly, this seems to occur regardless of the molecular status. These observations might have a considerable impact on clinical practice and research. Subsequent investigations will be needed to further understand the specific clinical and molecular characteristics of this growing group of patients to better define the more appropriate treatment strategy.
Legal entity responsible for the study
All authors.
Funding
Has not received any funding.
Disclosure
A. Pretta: Financial Interests, Personal, Speaker’s Bureau: Merck. All other authors have declared no conflicts of interest.