Metastatic Colorectal Cancer Outcomes by Age Among ARCAD First- and Second-Line Clinical Trials
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Metastatic Colorectal Cancer Outcomes by Age Among ARCAD First- and Second-Line Clinical Trials. / McCleary, Nadine J; Harmsen, William S; Haakenstad, Ellana; Cleary, James M; Meyerhardt, Jeffrey A; Zalcberg, John; Adams, Richard; Grothey, Axel; Sobrero, Alberto F; Van Cutsem, Eric; Goldberg, Richard M; Peeters, Marc; Tabernero, Josep; Seymour, Matt; Saltz, Leonard B; Giantonio, Bruce J; Arnold, Dirk; Rothenberg, Mace L; Koopman, Miriam; Schmoll, Hans-Joachim; Pitot, Henry C; Hoff, Paulo M; Tebbutt, Niall; Masi, Gianluca; Souglakos, John; Bokemeyer, Carsten; Heinemann, Volker; Yoshino, Takayuki; Chibaudel, Benoist; deGramont, Aimery; Shi, Qian; Lichtman, Stuart M.
In: JNCI CANCER SPECT, Vol. 6, No. 2, pkac014, 02.03.2022.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Metastatic Colorectal Cancer Outcomes by Age Among ARCAD First- and Second-Line Clinical Trials
AU - McCleary, Nadine J
AU - Harmsen, William S
AU - Haakenstad, Ellana
AU - Cleary, James M
AU - Meyerhardt, Jeffrey A
AU - Zalcberg, John
AU - Adams, Richard
AU - Grothey, Axel
AU - Sobrero, Alberto F
AU - Van Cutsem, Eric
AU - Goldberg, Richard M
AU - Peeters, Marc
AU - Tabernero, Josep
AU - Seymour, Matt
AU - Saltz, Leonard B
AU - Giantonio, Bruce J
AU - Arnold, Dirk
AU - Rothenberg, Mace L
AU - Koopman, Miriam
AU - Schmoll, Hans-Joachim
AU - Pitot, Henry C
AU - Hoff, Paulo M
AU - Tebbutt, Niall
AU - Masi, Gianluca
AU - Souglakos, John
AU - Bokemeyer, Carsten
AU - Heinemann, Volker
AU - Yoshino, Takayuki
AU - Chibaudel, Benoist
AU - deGramont, Aimery
AU - Shi, Qian
AU - Lichtman, Stuart M
N1 - © The Author(s) 2022. Published by Oxford University Press.
PY - 2022/3/2
Y1 - 2022/3/2
N2 - BACKGROUND: We evaluated the time to progression (TTP) and survival outcomes of second-line therapy for metastatic colorectal cancer among adults aged 70 years and older compared with younger adults following progression on first-line clinical trials.METHODS: Associations between clinical and disease characteristics, time to initial progression, and rate of receipt of second-line therapy were evaluated. TTP and overall survival (OS) were compared between older and younger adults in first- and second-line trials by Cox regression, adjusting for age, sex, Eastern Cooperative Oncology Group Performance Status, number of metastatic sites and presence of metastasis in the lung, liver, or peritoneum. All statistical tests were 2-sided.RESULTS: Older adults comprised 16.4% of patients on first-line trials (870 total older adults aged >70 years; 4419 total younger adults aged ≤70 years, on first-line trials). Older adults and those with Eastern Cooperative Oncology Group Performance Status >0 were less likely to receive second-line therapy than younger adults. Odds of receiving second-line therapy decreased by 11% for each additional decade of life in multivariable analysis (odds ratio = 1.11, 95% confidence interval = 1.02 to 1.21, P = .01). Older and younger adults enrolled in second-line trials experienced similar median TTP and median OS (median TTP = 5.1 vs 5.2 months, respectively; median OS = 11.6 vs 12.4 months, respectively).CONCLUSIONS: Older adults were less likely to receive second-line therapy for metastatic colorectal cancer, though we did not observe a statistical difference in survival outcomes vs younger adults following second-line therapy. Further study should examine factors affecting decisions to treat older adults with second-line therapy. Inclusion of geriatric assessment may provide better criteria regarding the risks and benefits of second-line therapy.
AB - BACKGROUND: We evaluated the time to progression (TTP) and survival outcomes of second-line therapy for metastatic colorectal cancer among adults aged 70 years and older compared with younger adults following progression on first-line clinical trials.METHODS: Associations between clinical and disease characteristics, time to initial progression, and rate of receipt of second-line therapy were evaluated. TTP and overall survival (OS) were compared between older and younger adults in first- and second-line trials by Cox regression, adjusting for age, sex, Eastern Cooperative Oncology Group Performance Status, number of metastatic sites and presence of metastasis in the lung, liver, or peritoneum. All statistical tests were 2-sided.RESULTS: Older adults comprised 16.4% of patients on first-line trials (870 total older adults aged >70 years; 4419 total younger adults aged ≤70 years, on first-line trials). Older adults and those with Eastern Cooperative Oncology Group Performance Status >0 were less likely to receive second-line therapy than younger adults. Odds of receiving second-line therapy decreased by 11% for each additional decade of life in multivariable analysis (odds ratio = 1.11, 95% confidence interval = 1.02 to 1.21, P = .01). Older and younger adults enrolled in second-line trials experienced similar median TTP and median OS (median TTP = 5.1 vs 5.2 months, respectively; median OS = 11.6 vs 12.4 months, respectively).CONCLUSIONS: Older adults were less likely to receive second-line therapy for metastatic colorectal cancer, though we did not observe a statistical difference in survival outcomes vs younger adults following second-line therapy. Further study should examine factors affecting decisions to treat older adults with second-line therapy. Inclusion of geriatric assessment may provide better criteria regarding the risks and benefits of second-line therapy.
U2 - 10.1093/jncics/pkac014
DO - 10.1093/jncics/pkac014
M3 - SCORING: Journal article
C2 - 35603849
VL - 6
JO - JNCI CANCER SPECT
JF - JNCI CANCER SPECT
SN - 2515-5091
IS - 2
M1 - pkac014
ER -