Care Patterns and Overall Survival in Patients With Early-Onset Metastatic Colorectal Cancer

Area of Science:

• Oncology
• Gastroenterology
• Clinical Research

Background:

• Colorectal cancer (CRC) incidence is rising in individuals under 50, termed early-onset CRC (EO-CRC).
• EO-CRC presents with unique features, but prognosis and outcomes with modern treatments remain unclear.

Purpose of the Study:

• To analyze treatment patterns and survival outcomes in metastatic CRC (mCRC) based on age at diagnosis.
• To compare early-onset (EO-CRC) and older-onset CRC patients regarding treatment intensity and prognosis.

Main Methods:

• Prospective enrollment of 466 mCRC patients (2014-2018) into a biobanking and data collection protocol.
• Cohort stratified into three age groups: <40, 40-49, and ≥50 years at diagnosis.
• Regression models used to assess associations between age, treatments, clinicopathologic features, and survival.

Main Results:

• Patients <40 years underwent more metastatic resections (OR, 3.533; P=.0066).
• EO-CRC patients received more triplet therapy (ORs 6.738-2.949; P≤.0166) and anti-EGFR therapy (OR, 2.633; P=.0016) compared to older patients.
• Despite intensive treatment, age at diagnosis did not predict overall survival.

Conclusions:

• Early-onset colorectal cancer patients receive more aggressive treatment but experience similar survival to older counterparts.
• EO-CRC exhibits clinical and molecular characteristics linked to poorer prognoses, necessitating further biological understanding.
• Careful evaluation of the cost-benefit of intensive treatments for EO-CRC is warranted.