Abstract 409P
Background
CC is a disease of the elderly patients (pts.) with a median age of 73 years (yrs.) in Germany. Since elderly pts. are underrepresented in randomized clinical trials, data on adjuvant chemotherapy (ACT) are scarce. We aimed to characterize the use of ACT and cancer related and non-cancer related death in an elderly cohort of the German CPP registry.
Methods
CPP assembles statistics from real world data (Reinacher-Schick ESMO 2018). Out of the registry we analyzed UICC stage III pts. aged ≥50 yrs. with information for follow up, ACT and a Charlson Co-morbidity Score (CCS) less than 5. Cause-specific Cox regressions with interaction between age and ACT and adjusted for CCS were used.
Results
Mean follow up was 23.3 months, 1149 pts. were analyzed concerning age: 50-<70 yrs./≥70 yrs.: 510 (44%) / 639 (56%); mean CCS: 0.57 (1.02 standard deviation (SD)) / 0.93 (1.18 SD; p=<0.001), ACT: 90.8%/63.4% (p<0.001), oxaliplatin containing treatment: 88.3%/39.1% (p<0.001). Treated pts. had a mean CCS of 0.65 (1.03) whereas not treated pts. 1.15 (1.31). In both age groups pts. treated with ACT had lower risk for cancer specific death (50-<70 yrs.: HR=0.32, p=0.002; ≥70 yrs: HR=0.49, p=0.003) and for death from other causes (50-<70 yrs.: HR=0.27, p=0.046; ≥70 yrs: HR=0.22, p<0.001). There was no significant difference in the effect of ACT between age groups (interaction: cancer specific HR=1.52, p=0.34; other cause HR=0.82, p=0.78).
Conclusions
In our registry a substantial number of elderly pts. received ACT including oxaliplatin. ACT was an independent positive prognostic factor for cause specific death in the elderly, suggesting, that there may be a cohort of elderly pts. with less co-morbidities and therefore also a lower risk of death from other causes who may benefit from ACT. Further characterization in prospective trials are needed to verify our findings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Institute of Pathology, Ruhr-University Bochum.
Funding
Roche.
Disclosure
S. Nöpel-Dünnebacke: Honoraria (self), Advisory/Consultancy: BMS; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution): Roche; Honoraria (self), Advisory/Consultancy: Merck; Travel/Accommodation/Expenses: Celgene. A-L. Kraeft: Travel/Accommodation/Expenses: Celgene. U. Graeven: Honoraria (self): Sirtex Medical; Honoraria (self): Daiichi Sankyo; Honoraria (self), Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Amgen; Honoraria (self): Servier; Honoraria (self): AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Merck KGaA; Advisory/Consultancy: Bristol-Myers Squibb; Advisory/Consultancy: Hexal; Advisory/Consultancy: Celgene; Advisory/Consultancy: Johnson & Johnson; Advisory/Consultancy: MSD Oncology. D. Arnold: Advisory/Consultancy, Speaker Bureau/Expert testimony: Bayer; Advisory/Consultancy, Speaker Bureau/Expert testimony: Lilly; Advisory/Consultancy, Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Roche; Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (institution): Sanofi; Advisory/Consultancy, Speaker Bureau/Expert testimony: Servier; Advisory/Consultancy, Speaker Bureau/Expert testimony: Sirtex; Advisory/Consultancy: Terumo; Speaker Bureau/Expert testimony: Biocompatibles; Speaker Bureau/Expert testimony: MSD; Research grant/Funding (institution): Mologen. A. Reinacher-Schick: Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Amgen; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy: BMS; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Celgene; Honoraria (self), Research grant/Funding (institution): Lilly; Honoraria (self), Advisory/Consultancy: Merck Serono; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: MSD; Honoraria (self), Advisory/Consultancy: Pfizer; Honoraria (self), Advisory/Consultancy, Research grant/Funding (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy: Sanofi-Aventis; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Servier; Advisory/Consultancy: Baxalta; Advisory/Consultancy, Travel/Accommodation/Expenses: Pierre Fabre; Research grant/Funding (institution): Mologen Berlin; Research grant/Funding (self), Research grant/Funding (institution): Ipsen. A. Tannapfel: Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Amgen; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Falk; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Celgene. All other authors have declared no conflicts of interest.