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Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients

Thomas Aparicio 1, * Dany Gargot Laurent Teillet Emilie Maillard 2 Dominique Genet Jacques Cretin Christophe Locher 3 Olivier Bouché 4 Gilles Breysacher 5 Jean-François Seitz 6 Mohamed Gasmi 7 Laetitia Stefani 8 Mohamed Ramdani Thierry Lecomte 9 Dominique Auby 10 Roger Faroux 11 Jean-Baptiste Bachet 12, 13, 14 Céline Lepère Faiza Khemissa Iradj Sobhani 15 Olivier Boulat Emmanuel Mitry 16 Jean-Louis Jouve 17
* Auteur correspondant
1 Service de Gastro-entérologie [Avicenne]
2 Fédération Francophone de la Cancérologie Digestive, FFCD
3 CHU Pontchaillou [Rennes]
4 CHU Reims - Centre Hospitalier Universitaire de Reims
5 Hôpitaux Civils Colmar
6 Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM]
7 IV - Image et ville
8 Département de cancérologie et d'hématologie
9 Service Hépato-gastroentérologie [Tours]
10 Département de Médecine
11 Centre Hospitalier Départemental Les Oudairies
12 MEPPOT - U1147 - Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique
13 UPMC - Université Pierre et Marie Curie - Paris 6
14 Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière]
15 Service de gastro-entérologie [Henri Mondor AP-HP, Créteil]
16 Institut Curie [Paris]
17 LNC - Lipides - Nutrition - Cancer [Dijon - U1231]
Abstract : AIM:Several predictors of metastatic colorectal cancer (mCRC) outcomes have been described. Specific geriatric characteristics could be of interest to determine prognosis.METHOD:Elderly patients (75+) with previously untreated mCRC were randomly assigned to receive infusional 5-fluorouracil-based chemotherapy, either alone (FU) or in combination with irinotecan (IRI). Geriatric evaluations were included as an optional procedure. The predictive value of geriatric parameters was determined for the objective response rate (ORR), progression-free survival (PFS) and overall survival (OS).RESULTS:From June 2003 to May 2010, the FFCD 2001-02 randomised trial enrolled 282 patients. A baseline geriatric evaluation was done in 123 patients; 62 allocated to the FU arm and 61 to the IRI arm. The baseline Charlson index was ≤1 in 75%, Mini-Mental State Examination was ≤27/30 in 31%, Geriatric Depression Scale was >2 in 10% and Instrumental Activities of Daily Living (IADL) was impaired in 34% of the patients. Multivariate analyses revealed that no geriatric parameter was predictive for ORR or PFS. Normal IADL was independently associated with better OS. The benefit of doublet chemotherapy on PFS differed in subgroups of patients ≤80 years, with unresected primary tumour, leucocytes >11,000 mm3 and carcinoembryonic antigen >2N. There was a trend towards better OS in patients with normal IADL.CONCLUSION:The autonomy score was an independent predictor for OS. A trend toward a better efficacy of doublet chemotherapy in some subgroups of patients was reported and should be further explored.
Keywords : Colorectal cancer Elderly Prognostic factors Irinotecan Geriatric assessment
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01507477
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Soumis le : jeudi 13 avril 2017 - 11:43:02
Dernière modification le : mardi 11 janvier 2022 - 10:35:21

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UNIV-BOURGOGNE | CNRS | UNIV-PARIS5 | UPMC | CURIE | FNCLCC | UNIV-PARIS13 | LNC-UMR866 | USPC | SORBONNE-UNIVERSITE | SORBONNE-PARIS-NORD | SITE-ALSACE | UNIV-PARIS | PSL

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Thomas Aparicio, Dany Gargot, Laurent Teillet, Emilie Maillard, Dominique Genet, et al.. Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients. European Journal of Cancer, Elsevier, 2017, 74, pp.98 - 108. ⟨10.1016/j.ejca.2016.09.029⟩. ⟨hal-01507477⟩

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