Irinotecan/fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer: Combined analysis of 2,691 patients in randomized controlled trials
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
Abstract
PURPOSE: Uncertainty exists about whether elderly patients benefit to the same extent as younger patients from combination therapy with irinotecan in the first-line treatment of metastatic colorectal cancer (CRC).
PATIENTS AND METHODS: Combined analysis was carried out with source data from the fluorouracil (FU)/folinic acid (FA) and the irinotecan/FU/FA arms of four first-line, phase III trials of CRC to investigate the efficacy and safety of combination and monotherapy in elderly (age > or = 70 years; n = 599) compared with younger (age < 70 years; n = 2,092) patients.
RESULTS: Response rates were improved with irinotecan-based combination therapy compared with FU/FA in patients both younger than 70 years and > or = 70 years (46.6% v 29.0% P < .0001; and 50.5% v 30.3%, P < .0001, respectively). With irinotecan/FU/FA, progression-free survival was better for both younger (hazard ratio [HR], 0.77; 95% CI, 0.70 to 0.85; P < .0001) and elderly patients (HR, 0.75; 95% CI, 0.61 to 0.90; P = .0026). In younger patients, overall survival was improved with combination therapy (HR, 0.83; 95% CI, 0.75 to 0.92; P = .0003). The same trend was observed in elderly patients (HR, 0.87; 95% CI, 0.72 to 1.05; P = .15). There was no significant interaction between treatment arm and age in the regression analysis. The expected differences in toxicity between combination and monotherapy in elderly and younger patients were observed. A significant interaction between treatment and age (cutoff, 70 years) for vomiting and hepatotoxicity was not confirmed by analysis that used age as a continuous variable.
CONCLUSION: Patients older than 70 years of age who were selected for inclusion in phase III trials derived similar benefits as younger patients from irinotecan-containing chemotherapy, and the risk of toxicity was similar.
Details
Originalsprache | Englisch |
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Seiten (von - bis) | 1443-1451 |
Seitenumfang | 9 |
Fachzeitschrift | Journal of Clinical Oncology |
Jahrgang | 26 |
Ausgabenummer | 9 |
Publikationsstatus | Veröffentlicht - 20 März 2008 |
Peer-Review-Status | Ja |
Konferenz
Titel | 43rd Annual Meeting of the American-Society-of-Clinical-Oncology |
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Dauer | 1 - 5 Juni 2007 |
Stadt | Chicago |
Land | Israel |
Externe IDs
Scopus | 41149180580 |
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PubMed | 18349394 |
WOS | 000254178600010 |
ORCID | /0000-0002-9321-9911/work/142251933 |
Schlagworte
Ziele für nachhaltige Entwicklung
Schlagwörter
- Elderly-patients, Adjuvant chemotherapy, Clinical-trials, Pooled analysis, Colon-cancer, Fluorouracil failure, Continuous-infusion, Irinotecan, Leucovorin, Oxaliplatin