First-Line Biological Agents Plus Chemotherapy in Older Patients with Metastatic Colorectal Cancer: A Retrospective...

Area of Science:

• Oncology
• Clinical Pharmacology
• Geriatric Medicine

Background:

• First-line treatment for metastatic colorectal cancer (mCRC) often involves biologicals combined with chemotherapy.
• Limited evidence exists regarding the optimal management of mCRC in older adult populations.
• This study addresses the gap in understanding treatment efficacy and safety for elderly mCRC patients.

Purpose of the Study:

• To compare efficacy and safety outcomes of first-line biological therapy in older (≥ 65 years) versus younger (< 65 years) patients with mCRC.
• To evaluate progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety profiles.
• To provide evidence-based guidance for treating elderly patients with mCRC.

Main Methods:

• Retrospective analysis of pooled data from five clinical trials.
• Inclusion of adult patients with advanced CRC receiving first-line chemotherapy plus bevacizumab, cetuximab, or panitumumab.
• Stratification of patients by age (≥ 65 vs. < 65 years) with analysis of PFS, OS, ORR, and safety outcomes.

Main Results:

• No significant difference in median progression-free survival (PFS) between older and younger patients (9.9 vs. 9.4 months).
• Older patients had significantly shorter median overall survival (OS) (21.3 vs. 25.0 months).
• Older patients (≥ 65 years) experienced significantly more grade 3 or higher adverse events (61.67% vs. 45.86%).

Conclusions:

• Biologicals plus chemotherapy represent an effective first-line treatment for selected older patients (≥ 65 years) with mCRC.
• The efficacy in older patients is comparable to that observed in younger patients.
• The safety profile is manageable, despite a higher incidence of adverse events in the elderly population.