Efficacy and safety of FOLFIRI/aflibercept (FA) in an elderly population with metastatic colorectal cancer (mCRC) after failure of an oxaliplatin-based regimen.

Autor: Martínez-Lago N; Medical Oncology Department, University Hospital A Coruña, A Coruña, Spain., Cameselle García S; Medical Oncology Department, Ourense University Hospital Complex, Ourense, Spain., Alonso de Castro B; Medical Oncology Department, University Hospital A Coruña, A Coruña, Spain., Gómez-Randulfe Rodríguez MI; Medical Oncology Department, University Hospital A Coruña, A Coruña, Spain., Carmona Campos M; Medical Oncology Department, University Hospital Lucus Augusti, Lugo, Spain., González Villarroel P; Medical Oncology Department, Alvaro Cunqueiro University Hospital, Vigo, Spain., Salgado Fernández M; Medical Oncology Department, Ourense University Hospital Complex, Ourense, Spain., De la Cámara Gómez JC; Medical Oncology Department, University Hospital A Coruña, A Coruña, Spain., Romero Reinoso C; Medical Oncology Department, POVISA, Vigo, Spain., Cousillas Castiñeiras A; Medical Oncology Department, Pontevedra University Hospital Complex, Pontevedra, Vigo, Spain., Méndez Méndez JC; Medical Oncology Department, Centro Oncológico de Galicia, A Coruña, Spain., Vidal Insua Y; Medical Oncology Department, Santiago University Hospital Complex, Santiago de Compostela, A Coruña, Spain., Fernández-Montes A; Medical Oncology Department, Ourense University Hospital Complex, Ourense, Spain.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Jun 03; Vol. 17 (6), pp. e0269399. Date of Electronic Publication: 2022 Jun 03 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0269399
Abstrakt: Background: The VELOUR study showed the benefit of FOLFIRI-Aflibercept (FA) versus FOLFIRI in patients with metastatic colorectal cancer (mCRC) in second-line treatment. However, only 36% of the included patients were ≥65 years. Thus, we seek to evaluate the efficacy and safety of FA in the elderly population in the context of routine practice.
Materials and Methods: We conducted an observational, retrospective, multicenter, observational study of patients ≥70 years with mCRC treated with FA after progression to oxaliplatin chemotherapy in routine clinical practice in 9 hospitals of the GITuD group.
Results: Of 388 patients treated with FA between June 2013 and November 2018, 75 patients ≥70 years were included. The median number of cycles was 10 and the objective response (ORR) and disease control rates (DCR) were 33.8% and 72.0%, respectively. With a median follow-up of 27.1 months, median Progression-free survival (PFS) was 6.6 months and median Overall Survival (OS) was 15.1 months. One third fewer metastasectomies were performed in the ≥75 years' subgroup (24 vs. 52%, p = 0.024) and more initial FOLFIRI dose reductions (68 vs. 36%, p = 0.014). ORR (23.8% vs. 38.3%), DCR (42.8% vs. 85.1%), and PFS (4 vs. 7.8 months; p = 0.017) were significantly less, without difference in OS (9.9 vs. 17.1 months; p = 0.129). The presence of prior hypertension (HT) (PFS 7.9 vs. 5.7 months, p = 0.049) and HT ≥ grade 3 during treatment (PFS 7.6 vs. 6.6 months, p = 0.024) were associated with longer PFS. The most frequent grade 3/4 adverse events were: asthenia (21.3%), neutropenia (14.7%), and diarrhea (14.7%). 57.3% required FOLFIRI dose reduction; 34.7% of aflibercept, including discontinuation (5.3% and 18.7%, respectively).
Conclusions: FA combination is effective in patients ≥70 years. The occurrence of HT is predictive of efficacy. Close monitoring of toxicity and initial dose adjustment is recommended.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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