Survival in Young-Onset Metastatic Colorectal Cancer: Findings From Cancer and Leukemia Group B (Alliance)/SWOG 80405.

Abstract

BACKGROUND:

The incidence of young-onset colorectal cancer (yoCRC) is increasing. It is unknown if there are survival differences between young and older patients with metastatic colorectal cancer (mCRC).

METHODS:

We studied the association of age with survival in 2326 mCRC patients enrolled in the Cancer and Leukemia Group B and SWOG 80405 trial, a multicenter, randomized trial of first-line chemotherapy plus biologics. The primary and secondary outcomes of this study were overall survival (OS) and progression-free survival (PFS), respectively, which were assessed by Kaplan-Meier method and compared among younger vs older patients with the log-rank test. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards modeling, adjusting for known prognostic variables. All statistical tests were 2-sided.

RESULTS:

Of 2326 eligible subjects, 514 (22.1%) were younger than age 50 years at study entry (yoCRC cohort). The median age of yoCRC patients was 44.3 vs 62.5 years in patients aged 50 years and older. There was no statistically significant difference in OS between yoCRC vs older-onset patients (median = 27.07 vs 26.12 months; adjusted HR = 0.98, 95% CI = 0.88 to 1.10; P = .78). The median PFS was also similar in yoCRC vs older patients (10.87 vs 10.55 months) with an adjusted hazard ratio of 1.02 (95% CI = 0.92 to 1.13; P = .67). Patients younger than age 35 years had the shortest OS with median OS of 21.95 vs 26.12 months in older-onset patients with an adjusted hazard ratio of 1.08 (95% CI = 0.81 to 1.44; Ptrend = .93).

CONCLUSION:

In this large study of mCRC patients, there were no statistically significant differences in survival between patients with yoCRC and CRC patients aged 50 years and older.

• Authors: Marla Lipsyc-Sharf, Sui Zhang, Fang-Shu Ou, Chao Ma, Nadine Jackson McCleary, Donna Niedzwiecki, I-Wen Chang, Heinz-Josef Lenz, Charles D Blanke, Sorbarikor Piawah, Katherine Van Loon, Tiffany M Bainter, Alan P Venook, Robert J Mayer, Charles S Fuchs, Federico Innocenti, Andrew B Nixon, Richard Goldberg, Eileen M O'Reilly, Jeffrey A Meyerhardt, Kimmie Ng
• Journal: Journal of the National Cancer Institute (J Natl Cancer Inst) Vol. 114 Issue 3 Pg. 427-435 (03 08 2022) ISSN: 1460-2105 [Electronic] United States
• PMID: 34636852 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: © The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: [email protected].

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Colonic Neoplasms (drug therapy)
• Colorectal Neoplasms (pathology)
• Humans
• Leukemia (drug therapy)
• Middle Aged
• Progression-Free Survival
• Rectal Neoplasms (drug therapy)