Townsley Carol A, Pond Gregory R, Oza Amit M, Hirte Hal W, Winquist Eric, Goss Glenwood, Degendorfer Pamela, Moore Malcolm J, Siu Lillian L
Princess Margaret Hospital Phase II Consortium, Ontario, Canada.
Clin Cancer Res. 2006 Apr 1;12(7 Pt 1):2141-9. doi: 10.1158/1078-0432.CCR-05-1798.
The tolerability of molecularly targeted agents in older patients has not been specifically examined. Adverse event data from clinical trials in the Princess Margaret Hospital Phase II Consortium database were analyzed to address this question.
The Consortium database collects trial information on all patients treated with either a molecularly targeted agent alone or in combination since 2001. The frequency of adverse events was determined and analyzed by two different age groups, <65 years and >/=65 years. Toxicity indices (TI) and frequencies of dose-limiting toxicities (DLT), based on adverse events of all causalities (TI(ALL) and DLT(ALL)), and on adverse events that were at least possibly related to the molecularly targeted agent (TI(MTA) and DLT(MTA)), were calculated for both age groups.
Four hundred and one patients who received 1,252 treatment cycles were analyzed from 19 different studies. Baseline performance status was similar between both age groups, but fewer older patients have had multiple prior regimens of chemotherapy or prior radiation therapy. A comparison of the proportions of younger and older patients experiencing DLT(ALL) and DLT(MTA) showed similar results. The TI(MTA) values were comparable between the two age groups in both single agent (3.25 versus 3.00, for <65 versus >/=65 years) and multi-agent (3.65 versus 3.00, for <65 versus >/=65 years) trials.
Older patients seem to tolerate molecularly targeted therapies either alone or in combination with chemotherapy as well as younger patients. Age alone should not be a barrier in the administration of targeted agents.
分子靶向药物在老年患者中的耐受性尚未得到专门研究。分析了玛格丽特公主医院II期联合数据库中临床试验的不良事件数据,以解决这一问题。
该联合数据库收集了自2001年以来所有接受单药或联合分子靶向药物治疗患者的试验信息。通过两个不同年龄组(<65岁和≥65岁)确定并分析不良事件的发生率。基于所有因果关系的不良事件(TI(ALL)和DLT(ALL))以及至少可能与分子靶向药物相关的不良事件(TI(MTA)和DLT(MTA)),计算两个年龄组的毒性指数(TI)和剂量限制毒性(DLT)发生率。
对来自19项不同研究的401例接受1252个治疗周期的患者进行了分析。两个年龄组的基线表现状态相似,但老年患者接受多种既往化疗方案或既往放疗的较少。比较年轻和老年患者发生DLT(ALL)和DLT(MTA)的比例,结果相似。在单药试验(<65岁组与≥65岁组分别为3.25对3.00)和多药试验(<65岁组与≥65岁组分别为3.65对3.00)中,两个年龄组的TI(MTA)值相当。
老年患者似乎与年轻患者一样能耐受单独或联合化疗的分子靶向治疗。仅年龄不应成为给予靶向药物的障碍。