FOLFOX4 in the treatment of metastatic colorectal cancer in elderly patients: A prospective study

Berretta, Massimiliano; Cappellani, Alessandro; Fiorica, Francesco; Nasti, Guglielmo; Frustaci, S.; Fisichella, R; Bearz, Alessandra; Talamini, Renato; Lleshi, Arben; Tambaro, Rosa; Cocciolo, Alessandro; Ristagno, Maurizio; Bolognese, Antonio; Burzotta, Francesco; Meneguzzo, Nereo; Berretta, Salvatore; Tirelli, Umberto

doi:10.1016/j.archger.2010.02.006

Cited by 17 publications

(13 citation statements)

References 34 publications

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“…In previous studies, dose reduction of radiation therapy or chemotherapy was required in 4.2–37.3% [25–27]. The rates of severe acute and late toxicities in our analysis were better than those of previously published clinical trials [24–27], and according to those studies, we found that gastrointestinal toxicity and skin reactions were more represented. Moreover, the rates of pCR (16.6%) and sphincter preservation (77.78%) were higher than other trials (0.8–16.6% and 52–64%, resp.).…”

Section: Discussioncontrasting

confidence: 48%

“…As a consequence of the little recruitment of elderly patients in clinical trial, our judgment of the appropriateness of therapeutic strategy is severely inadequate. Considering that in the literature there is no clear definition of “elderly” patients and that the chronological age could be very different from biological age [9], the choice of initial treatment should be influenced mostly by comorbidities and potential therapy side effects [24]. The last published ESMO Consensus Guidelines have been explicitly detailed that there is no age limit for the choice of treatment strategy in elderly patients with rectal cancer [2].…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer

Felice

Musio

Izzo

et al. 2013

BioMed Research International

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Purpose. To evaluate the treatment tolerance and clinical outcomes in patients aged 70 and older with locally advanced rectal carcinoma treated with multimodality approach. Methods and Materials. We retrospectively analysed 20 consecutive elderly patients, with histologically proven rectal adenocarcinoma, staged T3-4, and/or node-positive tumour, who received chemoradiotherapy and proceeded to surgical approach. Performance status score and adult comorbidity evaluation-27 score were calculated, and their influence on treatment tolerance and clinical outcomes was analysed. Results. All patients completed programmed chemoradiotherapy treatment. Gastrointestinal toxicity was the most common acute side effects: proctitis in 70% of patients and diarrhoea in 55%, classified as Grade 3 in 3 patients only. Radiation dermatitis was reported in 7 patients (35%) and it was graded G3 in one patient. There was no haematological toxicity. Eighteen patients out of 20 underwent surgery. Sphincter preservation was assured in 13 patients. Comorbidity index was related to higher severe acute toxicity (P = 0.015) but no influenced treatment outcomes. Conclusion. Treatment tolerance with combined modality is good in elderly patients. Due to age, no dose reduction for radiation therapy and chemotherapy should be considered.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Preoperative Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer

Felice

Musio

Izzo

et al. 2013

BioMed Research International

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“…These results appear to compare favourably with other studies in elderly patients treated with bevacizumab plus chemotherapy (Puthillath et al , 2009; Vrdoljak et al , 2011; Wong et al , 2011; Rosati et al , 2013) or cetuximab with or without chemotherapy (Sastre et al , 2011; Abdelwahab et al , 2012; Sastre et al , 2012). Furthermore, our survival data appear to compare well with those from studies in which elderly patients were treated with chemotherapy alone, although such comparisons are made with caution as patient characteristics, inclusion criteria and other variables may differ between trials (Sastre et al , 2009; Rosati et al , 2010; Berretta et al , 2011; Benavides et al , 2012). These and other data, however, suggest that the addition of bevacizumab to doublet chemotherapy can be beneficial for appropriate elderly patients with colorectal cancer.…”

Section: Discussionmentioning

confidence: 55%

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

et al. 2014

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Background:Subgroup analyses of clinical studies suggest that bevacizumab plus XELOX is effective and tolerable in elderly patients with metastatic colorectal cancer (mCRC). The prospective BECOX study examined the efficacy and safety of bevacizumab plus XELOX, followed by bevacizumab plus capecitabine in elderly patients with mCRC.Methods:Patients aged ⩾70 years with Eastern Cooperative Oncology Group performance status 0 out of 1 and confirmed mCRC were included. Patients received bevacizumab 7.5 mg kg−1 and oxaliplatin 130 mg m−2 on day 1, plus capecitabine 1000 mg m−2 bid orally on days 1–14 every 21 days; oxaliplatin was discontinued after 6 cycles. The primary end point was time to progression (TTP).Results:The intent-to-treat population comprised 68 patients (65% male, median age 76 years). Median TTP was 11.1 months; median overall survival was 20.4 months; overall response rate was 46%. Grade 3 or 4 adverse events included diarrhoea (18%) and asthenia (16%). Grade 3 or 4 adverse events of special interest for bevacizumab included deep-vein thrombosis (6%) and pulmonary embolism (4%).Conclusions:Bevacizumab plus XELOX was effective and well tolerated in elderly patients in the BECOX study. The adverse-event profile was similar to previous reports; no new safety concerns were identified. Fit elderly patients with mCRC should be considered for treatment with bevacizumab plus XELOX.

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“…Paik observed that only patients with high-risk of developing metastases within 10 years have benefitted from chemotherapy administration [91]. Some author propose that the patients’ wishes, estimated life expectancy, presence of comorbid conditions, and estimated benefit from treatment should be considered before any kind of adjuvant therapy [86,87]. …”

Section: Resultsmentioning

confidence: 99%

Prognostic factors in elderly patients with breast cancer

et al. 2013

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BackgroundBreast cancer (BC) remains principally a disease of old ages; with 35-50% of cases occurring in women older than 65 years. Even mortality for cancer increases with aging: 19.7% between 65 and 74 years; 22.6% between 75 and 84 years; and 15.1% in 85 years or more.The study was aimed to investigate specific predictive factors for elderly patients so to select the best way to treat and follow these patients.MethodsA search was performed on Medline, Embase, Scopus using the following Key words: Breast cancer, Breast neoplasms, Aged, Elder, Elderly, Eldest, Older, Survival analysis, Prognosis, Prognostic factors, Tumor markers, Biomarkers, Comorbidity, Geriatric assessment, Axilla, Axillary surgery. 3029 studies have been retrieved. Paper in which overall or disease free survival were not end points, or age class was not well defined, or the sample was too small, were excluded. At last 42 papers fulfilled the criteria.Results and discussionLack of screening and delay in diagnosis may be responsible for the minor improvement in survival observed in elderly respect to younger breast cancer patients. Predictive factors are the same and must be assessed with the same attention reserved to younger women.ConclusionsMost of elderly patient are fit to undergo standard treatment and can get the same benefits of younger women. Nevertheless it is possible that some older women with early breast cancer can be spared too aggressive treatments. Geriatric assessment and co-morbidities can affect the prognosis modifying surveillance, life expectancy and compliance to therapies. They can thus be useful to select the better treatment, either surgical or radio or hormone - or chemo-therapy.

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FOLFOX4 in the treatment of metastatic colorectal cancer in elderly patients: A prospective study

Cited by 17 publications

References 34 publications

Preoperative Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer

Preoperative Chemoradiotherapy in Elderly Patients with Locally Advanced Rectal Cancer

First-line bevacizumab and capecitabine–oxaliplatin in elderly patients with mCRC: GEMCAD phase II BECOX study

Prognostic factors in elderly patients with breast cancer

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