Quality of life, effectiveness, and safety of aflibercept plus FOLFIRI in older patients with metastatic colorectal cancer

• Verfasst von: Piringer, Gudrun [VerfasserIn]
• Verfasst von: Thaler, Josef [VerfasserIn]
• Verfasst von: Anchisi, Sandro [VerfasserIn]
• Verfasst von: Geffriaud-Ricouard, Christine [VerfasserIn]
• Verfasst von: Gueldner, Max [VerfasserIn]
• Verfasst von: Scholten, Felicitas [VerfasserIn]
• Verfasst von: Derigs, Hans-Günter [VerfasserIn]
• Verfasst von: Bohanes, Pierre [VerfasserIn]
• Verfasst von: Grünberger, Birgit [VerfasserIn]
• Verfasst von: Schwarz, Leonora [VerfasserIn]
• Verfasst von: von Moos, Roger [VerfasserIn]
• Verfasst von: Hofheinz, Ralf-Dieter [VerfasserIn]
• Titel: Quality of life, effectiveness, and safety of aflibercept plus FOLFIRI in older patients with metastatic colorectal cancer
• Titelzusatz: an analysis of the prospective QoLiTrap study
• Verf.angabe: Gudrun Piringer, Josef Thaler, Sandro Anchisi, Christine Geffriaud-Ricouard, Max Gueldner, Felicitas Scholten, Hans-Günter Derigs, Pierre Bohanes, Birgit Grünberger, Leonora Schwarz, Roger von Moos, Ralf-Dieter Hofheinz
• E-Jahr: 2023
• Jahr: November 2023
• Umfang: 10 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 28. September 2023, Artikelversion: 28. September 2023 ; Gesehen am 18.07.2024
• Titel Quelle: Enthalten in: Journal of geriatric oncology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 2010
• Jahr Quelle: 2023
• Band/Heft Quelle: 14(2023), 8, Artikel-ID 101638, Seite 1-10
• ISSN Quelle: 1879-4076
• DOI: doi:10.1016/j.jgo.2023.101638
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aflibercept
• Sach-SW: Antiangiogenics
• Sach-SW: Bevacizumab
• Sach-SW: Colorectal cancer
• Sach-SW: EGFR inhibitors
• Sach-SW: Older adults
• Sach-SW: Quality of life
• Sach-SW: Safety
• Sach-SW: VEGF inhibitors
• K10plus-PPN: 1895740460

Abstract

Introduction - Colorectal cancer (CRC) mainly affects older patients. The pivotal VELOUR phase III trial of aflibercept plus FOLFIRI in metastatic CRC (mCRC) included only 5.9% of patients aged ≥75 years. Herein, we report a preplanned analysis from QoLiTrap, a large prospective observational study evaluating the impact of age on quality of life (QoL), effectiveness, and safety of aflibercept plus FOLFIRI in daily clinical practice in Europe. - Materials and Methods - Enrolled patients had progressive mCRC, had failed a prior oxaliplatin-based regimen, and had received aflibercept (4 mg/kg) plus FOLFIRI every two weeks until disease progression, death, unacceptable toxicity, or physician/patient decision. Analyses were performed by age classes (<60, 60-64, 65-69, 70-74, and ≥ 75 years). The primary endpoint was the percentage of patients whose global health status (GHS) of the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was maintained (i.e., no worsening from baseline by at least 5% over a 12-week treatment). Secondary endpoints included tumor objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety. - Results - Overall, 1277 patients (<60 years, n = 327; 60-64 years, n = 231; 65-69 years, n = 227; 70-74 years, n = 259; and ≥ 75 years, n = 233) were treated, of whom 872 were evaluable for QoL. GHS was maintained in 36.5%, 41.6%, 38.9%, 41.8%, and 44.8% of patients aged <60, 60-64, 65-69, 70-74, and ≥ 75 years, respectively. Age did not influence PFS (median 7.8 months), OS (median 14.4 months), or ORR (20.8%). Number of cycles, dose delays for any cause, and dose reductions for adverse events (AEs) were comparable between age classes. Grade ≥ 3 AEs occurred in 47.7%, 51.9%, 51.5%, 55.2%, and 55.8% of patients aged <60, 60-64, 65-69, 70-74, and ≥ 75 years, respectively. The main grade ≥ 3 AEs were hypertension (11.2%) and diarrhea (9%) in patients aged ≥75 years. - Discussion - The results suggest that aflibercept plus FOLFIRI maintains QoL and retains its activity, including a high objective tumor response, regardless of age and treatment line. In fit older patients, the safety profile seems manageable, with no new safety signals.