Population-based analysis of patients with advanced colorectal cancer: The impact of age on treatment and outcomes

Abstract

3614 Background: 5-fluorouracil-based chemotherapy provides a significant survival benefit in older and younger patients with advanced colorectal cancer (ACRC). Recently, there have been a number of emerging therapies for metastatic CRC that have demonstrated efficacy. We conducted a population-based analysis to examine trends in systemic agent utilization and outcomes in older and younger cohorts. Methods: Patients with ACRC at presentation diagnosed in 2000 and 2002 were identified from the British Columbia Cancer Agency Registry. Information regarding baseline characteristics, treatment and outcomes was recorded. Patients were divided into two age cohorts: <70y (Group A, n= 261) and >=70y (Group B, n= 188). Survival was analyzed according to Kaplan-Meier estimates. Results: Patients in Group A were more likely to receive systemic therapy (70% vs 43%, p<0.001). Characteristics of treated versus untreated: Group A - male 62%/51%, median age 58/63, liver-limited metastases 74%/67%, PS>=2 29%/60%/Group B - male 65%/52%, median age 74/78, liver-limited metastases 74%/64%, PS>=2 33%/64%. First-line therapy with 5FU/capecitabine monotherapy or doublet therapy respectively was 33% and 61% in Group A and 69% and 26% in Group B. Median survival in Group A was 13.9 m versus 9.6m in Group B (p<0.0001). Survival for patients treated with monotherapy: Group A - 17.3 m, Group B - 10.8 m (p=0.0162). Survival for patients treated with doublet therapy: Group A - 17.5 m, Group B - 16.3 m (p=0.6418). Conclusions: Younger patients are more likely to receive palliative chemotherapy. At presentation, baseline characteristics of gender, extent of metastases and PS are similar between treated older and younger patients with ACRC. However, younger patients are more likely to receive doublet therapy. Among patients treated with doublet therapy, older patients achieved a similar magnitude of survival benefit when compared to their younger counterparts This work has been supported by a grant-in-aid by Hoffman LaRoche. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca