P-0239 - Toxicity Profile and Outcomes of Antiefgr Treatment in Elderly Patients with KRAS Wild-Type Metastatic Colorectal Cancer. Experience of Virgen DE Las Nieves University Hospital

Abstract

Introduction: The treatment with antiEGFR therapy (Cetuximab or Panitumumab) is a standard treatment in KRAS wild-type (KRASwt) metastatic colorectal cancer (mCRC) in monotherapy or in combination with chemotherapy. Elderly patients (pts) are underrepresented in clinical trials. The aim of this study is evaluate toxicity profile and outcomes in elderly patients with KRASwt mCRC and treated with antiEFGR therapy alone or in combination with chemotherapy. Methods: It has carried out a retrospective study of 23 pts >70 years with KRASwt mCRC who were treated at our institution between February 2008-August 2013 with antiEGFR therapy. Results: The median age of pts was 75 years (70-85). 73% were men, and 27% were women. All pts had ECOG 0-1 and KRASwt mCRC. 91% of pts received Cetuximab weekly (30%) or biweekly (70%) and 9% received Panitumumab at standard dosage in first (30.4% of pts), second (34.8% of pts) o third line (34.8% of pts) of treatment. 30% of pts received monoclonal antibody (mAb) in monotherapy and 70% (16 pts) in combination with chemotherapy: 13% of pts received FOLFOX in combination, 18% received FOLFIRI and 63% of pts received Irinotecan. 31% of pts had a grade 3-4 toxicity related chemotherapy: 1 pt (6% of pts) experienced grade 4 neutropenia, 1 pt experienced grade 4 cardiovascular toxicity, 2 pts (12% of pts) experienced grade 3 diarrhea and 1 pt experienced grade 4 alopecia. No toxic deaths. 65% of pts had cutaneous toxicity related mAb: 73% grade 1-2 toxicity and 27% grade 3-4 toxicity. 35% of pts had diarrhea related mAb and only 2 pts experienced grade 3 diarrhea. 33% of pts (n = 3) experienced hypersensitivity reactions to Cetuximab. 39% of pts had other grade 1-2 toxicities related mAb: asthenia, pruritus and conjunctivitis. 43.5% of pts required dose reduction of the mAb due to toxicity. 3 pts stopped treatment with mAb due toxicity. Response Rate (RR) was assessable in 87% of pts: 35% had a partial response (PR), 10% had stable disease (SD) and 55% of pts had progression disease. Median Progression Free Survival (PFS) was 6.8 months (1.7-15.5) and median Overall Survival (OS) was 10.52 months (1.7-37.6). Conclusion: In our experience treatment with antiEGFR therapy in elderly pts with KRASwt mCRC is feasible, with a manageable toxicity, and effective with a clinical benefit (PR + SD) of 45%, a PFS of 6.8 months and an OS of 10.5 months in previously treated pts mostly (70% of pts).