Abstract

ABSTRACT Background We designed a case-control phase II open, prospective non-randomized trial in elderly “fit” (≥65 yo) cancer patients (pts) compared to well-matched adult (45-65 yo) cancer pts to assess whether the same standard antineoplastic treatment could achieve comparable results as for efficacy and safety. Planned sample size: 125 pts per arm. Endpoints: safety, QoL, PFS, ORR, dose intensity. Patients and methods Only elderly “fit” pts at MGA were included. Inclusion criteria for elderly: histological diagnosis of cancer with either advanced disease with measurable lesions or radically resected (adjuvant setting); life expectancy >3 mo.; adequate baseline functional parameters; written informed consent. Inclusion criteria for adults: the same as for elderly plus ECOG-PS 0-1. Results At September 2011, 254 pts were enrolled, 127 elderly and 127 adults, all evaluable for toxicity. Elderly pts clinical characteristics: M/F ratio 69/58; mean age 70.8 ± 4.5 y. Adult pts: M/F ratio, 58/69; mean age 53 ± 5.4 y. Tumor sites: colo-rectal (23.5%), head and neck (16.4%), breast (14.1%), lung (11.7%), ovarian (9.3%); prostate (6.2%), NHL (4.7%), gastric (4.7%), liver (4.7%), uterus (3.9%), pancreas (0.8%); 92.1% of pts were stage IV, 5.9% stage III and 2.0% stage II. In the elderly no grade 4 toxicity were observed, hematological and non hematological grade 3 toxicities were observed in 12.21% and 13.8% of pts, respectively. In the adults, grade 4 hematological and non hematological toxicity were observed in 3.8% and 1.9% of pts, respectively; grade 3 hematological toxicity in 23.2% and non hematological toxicities in 21.3% of pts. The difference was statistically significant (p = 0.042) in favor of the elderly. At September 2011, 234 pts were assessable for response: the ORR was 50.7% for elderly and 51.1% for adults. No differences were observed for quality of life and dose intensity between the two groups. PFS was 10.6 mo. (3-12+ mo) for elderly and 9.05 mo. (3-12+) for adults. Conclusion The promising results of this single Institution study warrant to be confirmed by a larger clinical trial. Disclosure All authors have declared no conflicts of interest.

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