432P Toxicity and efficacy of 1st line cetuximab (cetux)-based therapy in RAS wildtype (WT) older patients (pts) with metastatic colorectal cancer (mCRC): A pooled analysis from 1,274 pts in the ARCAD database

Papamichael, D., Lopes, G. S., Olswold, C. L., Chibaudel, B., Zalcberg, J. R., Van Cutsem, E., Venook, A., Maughan, T., Heinemann, V., Kaplan, R. S., Bokemeyer, C., Lenz, H. J., Yoshino, T., Adams, R. A. ORCID: https://orcid.org/0000-0003-3915-7243, Grothey, A., De Gramont, A. and Shi, Q. 2020. 432P Toxicity and efficacy of 1st line cetuximab (cetux)-based therapy in RAS wildtype (WT) older patients (pts) with metastatic colorectal cancer (mCRC): A pooled analysis from 1,274 pts in the ARCAD database. Annals of Oncology 31 , S425. 10.1016/j.annonc.2020.08.543

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Abstract

Background With a median age at diagnosis of around 70 years (yrs), CRC is a disease that affects many older adults. We investigated the toxicity and efficacy of adding cetux to doublet chemotherapy (DC) in older pts. Methods RAS WT pts receiving 1st line DC + cetux (n = 932) or DC (n = 342) from 6 mCRC trials in the ARCAD database were included. Toxicity was measured by adverse events (AE) with CTCAE grade ≥ 3 (G3+) and compared by age group (≥ 70 vs < 70 yrs). OS and PFS between DC +/- cetux in 3 randomized trials were compared using stratified Cox model, adjusting for covariates. Interaction between age and treatment groups was tested. Associations between age groups for DC + cetuximab in all 6 trials were evaluated for outcomes and toxicity by multivariable cox model and logistic regression. Results RAS WT pts ≥ 70 yrs (age median [range] 73 [70-89], 70% male) were more likely than pts < 70 (age median [range] 58 [19-69], 63% male) to have PS 1 (50% vs 42%; p = 0.048), right colon (42% vs 29%; p = 0.013), and lung metastasis (40% vs 30%; p = 0.005). Pts ≥ 70 (vs < 70) had no difference in G3+ AE for neutropenia/leukopenia (23% vs 22%; p = 0.84), diarrhea (14% vs 12%; p = 0.83) or nausea/vomiting (9% vs 8%; p = 0.87). When comparing DC +/- cetux, no significant difference in OS was observed within each age group. PFS improved by adding cetux in pts < 70. Interaction tests were not significant. Pts ≥ 70 (vs < 70) receiving DC + cetux had similar PFS (HRadj [95% CI] = 1.23 [0.99 – 1.5]; p = 0.063) but inferior OS (HRadj [95% CI] = 1.38 [1.1 – 1.7]; p = 0.006).

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	0923-7534
Last Modified:	09 Nov 2022 10:06
URI:	https://orca.cardiff.ac.uk/id/eprint/138299

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