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Reduced-dose of doublet chemotherapy combined with anti-EGFR antibodies in vulnerable older patients with metastatic colorectal cancer: Data from the REVOLT study
- Source :
- Journal of Geriatric Oncology. 13:302-307
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Objectives To assess the toxicity patterns and effectiveness of doublet chemotherapy when administered at reduced doses of 20% (FOLFOX or FOLFIRI) in combination with anti-EGFR antibodies (cetuximab or panitumumab) in old, vulnerable patients with metastatic colorectal cancer (mCRC). Patients and methods We performed a retrospective observational study of RAS and BRAF wild-type, vulnerable patients aged ≥70 years with previously untreated mCRC. The primary endpoint was safety, and secondary endpoints were overall response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results One hundred and eighteen patients were collected from 14 selected Italian centres. The median age was 75 (range, 70–85). Geriatric screening by G8 tool gave a score ≤ 14 in all patients. In total, 75 and 43 patients received FOLFOX or FOLFIRI, respectively, in combination with panitumumab (53%) or cetuximab (47%). The overall incidence of grade (G) 3–4 neutropenia was 11.8%, and for skin rash 11%. The most frequent adverse events were G1–2 skin rash (49.1%), G1–2 diarrhea (21.1%) and G1–2 nausea (17.7%). The ORR was 57.3%. Stable disease was observed in 29.1% of patients, with a disease control rate of 86.4%. With a median follow-up of 18 months, the median PFS was 10.0 months (95% confidence interval [CI]: 8.5–11.4), while the median OS was 18.0 months (95% CI: 16.0–19.9). No statistically significant difference was observed between the regimens in terms of ORR, PFS (p = 0.908), and OS (p = 0.832). Conclusion This study shows that with an appropriate design, including reduced doses, vulnerable older patients best tolerate chemotherapy when combined with anti-EGFR antibodies.
- Subjects :
- medicine.medical_specialty
Reduced dose
Colorectal cancer
Leucovorin
Cetuximab
Neutropenia
Gastroenterology
FOLFOX
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Clinical endpoint
Humans
Panitumumab
Doublet chemotherapy
Anti-EGFR
Aged
Metastatic colorectal cancer
Rectal Neoplasms
business.industry
Anti-EGFRs Doublet chemotherapy Metastatic colorectal cancer Reduced doses Vulnerable older patients
Exanthema
medicine.disease
Rash
Vulnerable older patients
Oncology
Colonic Neoplasms
FOLFIRI
Fluorouracil
Geriatrics and Gerontology
medicine.symptom
Colorectal Neoplasms
business
medicine.drug
Subjects
Details
- ISSN :
- 18794068
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Journal of Geriatric Oncology
- Accession number :
- edsair.doi.dedup.....7233f9d64a80985716a5040f1ca4d9e6