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年龄≥70岁是转移性黑色素瘤试验入组患者不良事件的重要预测因素吗?治疗试验汇总分析的结果

Is Age ≥ 70 Years an Important Predictor of Adverse Events Among Patients Enrolled in Metastatic Melanoma Trials? Findings from Pooled Analyses of Therapeutic Trials.

作者信息

Jatoi Aminah, Allred Jacob B, Suman Vera J, Creagan Edward T, Croghan Gary A, Amatruda Thomas, Markovic Svetomir N

机构信息

Department of Oncology, Mayo Clinic, Rochester, Minnesota.

出版信息

J Geriatr Oncol. 2012 Oct 1;3(4):307-311. doi: 10.1016/j.jgo.2012.04.002. Epub 2012 May 7.

Abstract

BACKGROUND

The current study was undertaken to explore whether older age predicts adverse event rates in metastatic melanoma patients participating in cancer clinical trials. METHODS: Six phase II studies conducted at our institution for patients with metastatic disease were used in these pooled analyses: 1) ABT-510; 2) bortezomib, paclitaxel, and carboplatin; 3) everolimus; 4) bevacizumab, paclitaxel, carboplatin; 5) carboplatin and abraxane; and 6) temozolomide and everolimus. In total, 233 patients, 64 elderly (≥ 70 years) and 169 younger, were analyzed for age-based differences in grade 2 or worse adverse events and other clinical outcomes. RESULTS: Despite the fact that older patients had slightly worse performance scores, based on age, no differences in rates of adverse events were observed. Only worse baseline performance score predicted a higher rate of adverse events: patients with performance scores of one or worse were almost 4 times more likely to experience adverse events. Median cancer progression free survival and overall survival were comparable between older and younger patients. CONCLUSION: These findings suggest that concern for adverse event rates should not preclude the enrollment of elderly melanoma patients to cancer clinical trials. Such patients should continue to be monitored carefully for tumor response and toxicity.

摘要

背景

本研究旨在探讨年龄较大是否可预测参与癌症临床试验的转移性黑色素瘤患者的不良事件发生率。方法:在我们机构针对转移性疾病患者开展的6项II期研究被用于这些汇总分析:1)ABT - 510;2)硼替佐米、紫杉醇和卡铂;3)依维莫司;4)贝伐单抗、紫杉醇、卡铂;5)卡铂和白蛋白结合型紫杉醇;6)替莫唑胺和依维莫司。总共233例患者被分析基于年龄的2级或更严重不良事件及其他临床结局的差异,其中64例为老年患者(≥70岁),169例为年轻患者。结果:尽管老年患者的体能状态评分略差,但基于年龄未观察到不良事件发生率的差异。仅较差的基线体能状态评分预测了更高的不良事件发生率:体能状态评分为1分或更差的患者发生不良事件的可能性几乎高4倍。老年和年轻患者的癌症无进展生存期和总生存期的中位数相当。结论:这些发现表明,对不良事件发生率的担忧不应排除老年黑色素瘤患者参与癌症临床试验。此类患者仍应继续密切监测肿瘤反应和毒性。

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