3520 Background: CRC is primarily a disease of the elderly; however, the SEER database shows ∼10% of pts are age ≤50. Previous data suggested Y pts have worse outcomes. We sought to determine whether Y age is prognostic or influences efficacy or toxicity for aCRC pts treated with CT. Methods: We analyzed individual pt data on 6,286 subjects from 9 randomized phase III aCRC trials of 5FU-based single- agent and combination (comb) CT. Endpoints included progression-free survival (PFS), overall survival (OS), tumor response (RR), and grade ≥3 adverse events. Cox models stratified by study, and logistic-regression models adjusting for study, were used to test for age (<40 vs. ≥40; <50 vs. ≥50) effects and age-treatment interactions. Efficacy endpoints were explored in the full set of 9 trials and the subset of 5 studies comparing mono- to comb CT. Results: 793/6,286 (13%) were age <50, of which 188 pts (3% total) were <40. Comparing pts <50 to those ≥50: grade ≥3 nausea (N) (10% vs. 7%, p=0.01) was more common. However, rates of severe diarrhea (D) (11% vs. 14%, p=0.001) and neutropenia (NP) (23% vs. 26%, p<0.0001) were significantly lower in Y pts. Age was prognostic for PFS, with poorer outcomes in those <50 (median 6.0 vs. 7.5 months, HR=0.91, p=0.02), but it did not affect RR or OS. In the subset of mono- vs. comb CT trials, the relative PFS, OS, and ORR benefits of multi-agent CT were similar for Y and older pts (see Table). Results were comparable with the age 40 cutpoint. Conclusions: Based on a comparison with SEER, Y aCRC pts are proportionally represented on phase III studies. Y age is modestly associated with poorer PFS but not OS or RR in treated aCRC pts, and Y pts have more N but less D and NP with CT in general. Y vs. older pts derive the same benefits from comb CT. Based on these data, in the absence of a clinical trial, standard comb CT approaches are appropriate for Y aCRC pts. Age <50 Age ≥50 p value** Mono Comb HR/OR* Mono Comb HR/OR* Median PFS (months) 4.7 7.2 0.64 6.3 8.4 0.74 0.11 Median OS (months) 13.6 16.3 0.82 14.8 16.6 0.89 0.57 RR (%) 28 54 3.29 29 51 2.63 0.43 * HR of PFS/OS, OR for RR. ** p value testing for age by CT interaction. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen, AstraZeneca, Bristol-Myers Squibb, Genentech, ImClone Systems, Novartis, Pfizer, Roche, sanofi-aventis Roche, sanofi-aventis Amgen, Genentech
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