Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients.

Abstract

AIM:

Several predictors of metastatic colorectal cancer (mCRC) outcomes have been described. Specific geriatric characteristics could be of interest to determine prognosis.

METHOD:

Elderly patients (75+) with previously untreated mCRC were randomly assigned to receive infusional 5-fluorouracil-based chemotherapy, either alone (FU) or in combination with irinotecan (IRI). Geriatric evaluations were included as an optional procedure. The predictive value of geriatric parameters was determined for the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS).

RESULTS:

From June 2003 to May 2010, the FFCD 2001-02 randomised trial enrolled 282 patients. A baseline geriatric evaluation was done in 123 patients; 62 allocated to the FU arm and 61 to the IRI arm. The baseline Charlson index was ≤1 in 75%, Mini-Mental State Examination was ≤27/30 in 31%, Geriatric Depression Scale was >2 in 10% and Instrumental Activities of Daily Living (IADL) was impaired in 34% of the patients. Multivariate analyses revealed that no geriatric parameter was predictive for ORR or PFS. Normal IADL was independently associated with better OS. The benefit of doublet chemotherapy on PFS differed in subgroups of patients ≤80 years, with unresected primary tumour, leucocytes >11,000 mm3 and carcinoembryonic antigen >2N. There was a trend towards better OS in patients with normal IADL.

CONCLUSION:

The autonomy score was an independent predictor for OS. A trend toward a better efficacy of doublet chemotherapy in some subgroups of patients was reported and should be further explored.

• Authors: Thomas Aparicio, Dany Gargot, Laurent Teillet, Emilie Maillard, Dominique Genet, Jacques Cretin, Christophe Locher, Olivier Bouché, Gilles Breysacher, Jean-François Seitz, Mohamed Gasmi, Laetitia Stefani, Mohamed Ramdani, Thierry Lecomte, Dominique Auby, Roger Faroux, Jean-Baptiste Bachet, Céline Lepère, Faiza Khemissa, Iradj Sobhani, Olivier Boulat, Emmanuel Mitry, Jean-Louis Jouve, FFCD 2001-02 investigators
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 74 Pg. 98-108 (03 2017) ISSN: 1879-0852 [Electronic] England
• PMID: 27825697 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Chemical References

• Irinotecan
• Fluorouracil
• Camptothecin

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Camptothecin (administration & dosage, analogs & derivatives)
• Colorectal Neoplasms (drug therapy, mortality)
• Disease-Free Survival
• Female
• Fluorouracil (administration & dosage)
• Geriatric Assessment
• Humans
• Irinotecan
• Kaplan-Meier Estimate
• Karnofsky Performance Status
• Male
• Neoplasm Metastasis
• Prospective Studies
• Quality of Life
• Treatment Outcome