Abstract
e14040 Background: Data on B for elderly patients with advanced CRC are scarce, although recent analyses demonstrated safety for its use. To investigate the efficacy and safety of treating older pts with B and chemotherapy in the clinical practice a national cohort was analyzed. Methods: In this observational cohort study 213 elderly patients from 9 Italian centers who received first-line B combined with chemotherapy were enrolled. Demographics and comorbidities were captured, along with efficacy and toxicity results. Predefined endpoints were response rate, progression-free, overall survival, and safety. Survival curves were generated with Kaplan-Maier methodology. Results: Median age was 72 (66-84), PS was 0-1 in 96%. Comorbidities at study entry were reported in 153 pts (72%): cardiovascular (including hypertension) 107, diabetes 32, respiratory 15, endocrine 10, neurological 10, renal 7, other diseases 51. Comprehensive geriatric evaluation with ADL, IADL and CIRS scores was available for only 64 pts (29%) reporting median values of 6, 8 and 20 respectively. Companion chemotherapy was 5-FU alone for 27 (12.6%), oxaliplatin-based doublet for 75 (35.2%) and irinotecan-based combination for 111 (52.1%). 81 pts had chemotherapy dose reduction, and 23 interrupted B before progression. Disease control was achieved in 86%, with median PFS/OS of 8.8/18.9 months. 76 pts were maintained on B alone or B plus 5-FU. Main toxicities were neutropenia (44%), anemia (37.5%), diarrhea (40.8%), mucositis (25.8%) and hand-foot syndrome (14.1%). Sensorial neurotoxicity was frequent among pts receiving oxaliplatin. Specific B-induced toxicities were induced or worsened hypertension in 48 pts (22.5%), proteinuria in 24 (11%), and venous or artherial thromboembolism in 16 (7.5%). Conclusions: To treat elderly CRC pts with B and chemotherapy is safe and major efficacy endpoints did not differ from expected. Geriatric evaluation is underused in the common practice and better tools are required to select elderly to be treated with antiangiogenics.
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