Department of Medical Oncology, University General Hospital of Heraklion, Voutes and Stavrakia, PO BOX 1352, Heraklion, Crete 71110, Greece.
Department of Medical Oncology, University General Hospital of Heraklion, Voutes and Stavrakia, PO BOX 1352, Heraklion, Crete 71110, Greece.
J Geriatr Oncol. 2019 Jan;10(1):143-148. doi: 10.1016/j.jgo.2018.08.002. Epub 2018 Oct 23.
Although colorectal cancer (CRC) is a disease of the older patients, older patients are under-represented from randomized trials. Herein we conducted a retrospective analysis for the effect of panitumumab in the management of older patients (≥65 years) patients with metastatic CRC (mCRC) in the Hellenic Oncology Research Group's (HORG) database.
Τhe efficacy of panitumumab-based chemotherapy as front-line treatment in older patients with mCRC was assessed.
In total, 110 older patients with KRAS exon 2 wild type tumors were treated with chemotherapy plus panitumumab. The median age was 74 years; 69.9% of the patients were male, with left-sided primary tumors (78.2%), ECOG Performance Status 0-1 (95.4%) and median number of metastatic sites 2. Sixty-two (Overall Response Rate-ORR: 56.4%; 95% CI: 48.8%-68.1%) achieved an objective response, while 21 (19.1%) had stable disease. Median Progression free survival (PFS) was 9.4 months (95% CI: 7.8-11.0 months) and median Overall survival (OS) 23.0 months (95% CI: 20.6-25.3 months). Additionally, a statistically significant difference in ORR (62.7% vs. 33.3%; p = .014), median PFS (12.9 vs. 5.7 months; p = .001) and median OS (31.6 vs. 16.7 months; p < .001) was observed in patients with left-sided compared to right-sided primary tumor. There was no treatment-related death. Grade 3-4 toxicities were neutropenia (8.9%) and diarrhea (14.5%) whereas skin rash grade 2 or 3 was recorded in 41.1% and 10.7%, respectively.
The results of this retrospective study provide the evidence that combination chemotherapy plus panitumumab is active and well tolerated in older patients with mCRC.
尽管结直肠癌(CRC)是一种老年患者的疾病,但在随机试验中,老年患者的代表性不足。在此,我们在希腊肿瘤研究组(HORG)数据库中对帕尼单抗在管理转移性结直肠癌(mCRC)老年患者(≥65 岁)中的作用进行了回顾性分析。
评估了帕尼单抗为基础的化疗作为 mCRC 老年患者一线治疗的疗效。
共 110 例 KRAS 外显子 2 野生型肿瘤老年患者接受化疗联合帕尼单抗治疗。中位年龄为 74 岁;69.9%的患者为男性,原发肿瘤位于左侧(78.2%),ECOG 表现状态 0-1(95.4%),转移性部位中位数为 2 个。62 例(总体缓解率 ORR:56.4%;95%CI:48.8%-68.1%)达到客观缓解,21 例(19.1%)疾病稳定。中位无进展生存期(PFS)为 9.4 个月(95%CI:7.8-11.0 个月),中位总生存期(OS)为 23.0 个月(95%CI:20.6-25.3 个月)。此外,左侧原发性肿瘤患者的 ORR(62.7%比 33.3%;p=0.014)、中位 PFS(12.9 比 5.7 个月;p=0.001)和中位 OS(31.6 比 16.7 个月;p<0.001)有统计学显著差异。与右侧原发性肿瘤患者相比,左侧原发性肿瘤患者无治疗相关死亡。3-4 级毒性为中性粒细胞减少症(8.9%)和腹泻(14.5%),而皮疹 2 级或 3 级分别为 41.1%和 10.7%。
这项回顾性研究的结果表明,化疗联合帕尼单抗治疗转移性结直肠癌老年患者是有效且耐受良好的。