4.6 Article

Oxaliplatin-Based Chemotherapy in Patients with Metastatic Colorectal Cancer Aged at Least 75 Years: A Post-Hoc Subgroup Analysis of Three Phase II Trials

Journal

CANCERS
Volume 11, Issue 4, Pages -

Publisher

MDPI
DOI: 10.3390/cancers11040578

Keywords

colorectal cancer; doublet chemotherapy; elderly patients; oxaliplatin

Categories

Ask authors/readers for more resources

Patients older than 75 years of age are usually excluded from metastatic colorectal cancer studies based on a combination chemotherapy containing oxaliplatin. Our group conducted three phase II trials in elderly patients in recent years. A post-hoc subgroup analysis of 67 patients aged at least 75 years was included in this study. Oxaliplatin was combined with capecitabine in two trials and with uracil-tegafur (UFT) plus folinic acid in the third trial. In one study, bevacizumab was also added to chemotherapy. The median age of patients was 77 years, and all had a good performance status (0 to 1). The observed overall response rate was 45%, comparable to younger patients (51%, p = 0.49). The estimated median progression-free survival (PFS) time and overall survival (OS) time were 8.7 and 19.3 months, respectively. These results did not significantly differ from those in younger patients (8.0 months for PFS (p = 0.58) and 19.7 months for OS (p = 0.94), respectively). The most common grade 3-4 adverse events included diarrhea (13%), fatigue (13%), peripheral neuropathy (10%), and neutropenia (7%). Moreover, the toxicity was never statistically different from that in younger patients. The efficacy of oxaliplatin-based combination was maintained in fit elderly patients >= 75 years.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.6
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Oncology

A European, prospective, observational study of enzalutamide in patients with metastatic castration-resistant prostate cancer: PREMISE

Heather Payne, Angus Robinson, Bernard Rappe, Serena Hilman, Ugo De Giorgi, Steven Joniau, Roberto Bordonaro, Stephane Mallick, Louis-Marie Dourthe, Moises Mira Flores, Josep Guma, Benoit Baron, Aurea Duran, Alessandra Pranzo, Alexis Serikoff, David Mott, Mike Herdman, Marco Pavesi, Maria De Santis

Summary: In a real-world European setting, the study confirmed the efficacy and safety of enzalutamide in mCRPC patients, with outcomes consistent with clinical trial results. Patients showed improvements in health-related quality of life and pain status while experiencing similar rates of treatment-emergent adverse events across cohorts.

INTERNATIONAL JOURNAL OF CANCER (2022)

Article Oncology

Reduced-dose of doublet chemotherapy combined with anti-EGFR antibodies in vulnerable older patients with metastatic colorectal cancer: Data from the REVOLT study

Gerardo Rosati, Domenico Corsi, Antonio Avallone, Silvia Brugnatelli, Emanuela Dell'Aquila, Marika Cinausero, Giuseppe Aprile, Giuseppe Cicero, Chiara Carlomagno, Alfredo Colombo, Stefania Rapisardi, Carmine Pinto, Giorgio Reggiardo, Domenico Bilancia

Summary: This study demonstrates that vulnerable older patients can best tolerate chemotherapy when combined with anti-EGFR antibodies with an appropriate design, including reduced doses.

JOURNAL OF GERIATRIC ONCOLOGY (2022)

Article Pharmacology & Pharmacy

Cardiac Anthracycline Accumulation and B-Type Natriuretic Peptide to Define Risk and Predictors of Cancer Treatment-Related Early Diastolic Dysfunction

Giorgio Minotti, Emanuela Salvatorelli, Giorgio Reggiardo, Fabio Mangiacapra, Massimiliano Camilli, Pierantonio Menna

Summary: Diastolic dysfunction (DD) may occur before heart failure (HF) in cancer patients treated with chemotherapy. By analyzing data from patients treated with anthracyclines, it was found that the risk of DD is lower than the risk of HF and the levels of B-type natriuretic peptide (BNP) can help identify patients with high or low risk of DD.

JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS (2022)

Letter Oncology

From Cardiac Anthracycline Accumulation to Real-Life Risk for Early Diastolic Dysfunction

Giorgio Minotti, Giorgio Reggiardo, Massimiliano Camilli, Emanuela Salvatorelli, Pierantonio Menna

JACC: CARDIOONCOLOGY (2022)

Review Oncology

Risk Assessment and Pancreatic Cancer: Diagnostic Management and Artificial Intelligence

Vincenza Granata, Roberta Fusco, Sergio Venanzio Setola, Roberta Galdiero, Nicola Maggialetti, Lucrezia Silvestro, Mario De Bellis, Elena Di Girolamo, Giulia Grazzini, Giuditta Chiti, Maria Chiara Brunese, Andrea Belli, Renato Patrone, Raffaele Palaia, Antonio Avallone, Antonella Petrillo, Francesco Izzo

Summary: Pancreatic cancer is one of the deadliest cancers, and late diagnosis is the main reason for its high mortality rate. Surgical resection is the only curative treatment, so early diagnosis is crucial for improving survival. Therefore, it is appropriate to stratify patients based on familial and genetic risk and develop screening protocols using minimally invasive diagnostic tools.

CANCERS (2023)

Article Oncology

Carboplatin and paclitaxel plus avelumab compared with carboplatin and paclitaxel in advanced or recurrent endometrial cancer (MITO END-3): a multicentre, open-label, randomised, controlled, phase 2 trial

Sandro Pignata, Giovanni Scambia, Clorinda Schettino, Laura Arenare, Carmela Pisano, Davide Lombardi, Ugo De Giorgi, Claudia Andreetta, Saverio Cinieri, Carmine De Angelis, Domenico Priolo, Claudia Casanova, Marta Rosati, Filippo Greco, Elena Zafarana, Ilaria Schiavetto, Serafina Mammoliti, Sabrina Chiara Cecere, Vanda Salutari, Simona Scalone, Alberto Farolfi, Marilena Di Napoli, Domenica Lorusso, Piera Gargiulo, Daniela Califano, Daniela Russo, Anna Spina, Rossella De Cecio, Paolo Chiodini, Francesco Perrone

Summary: This study compared carboplatin and paclitaxel with avelumab plus carboplatin and paclitaxel as first-line treatment in patients with advanced or recurrent endometrial cancer. The addition of avelumab showed potential for improving progression-free survival, but further investigation is needed.

LANCET ONCOLOGY (2023)

Article Clinical Neurology

Cox regression and survival analysis from the tauro-urso-deoxycholic trial in amyotrophic lateral sclerosis

Giorgio Reggiardo, Maria Lo Giudice, Stefania Lalli, Gilberto Rinaldi, Alberto Albanese

Summary: Recent phase II pilot clinical trials showed that TUDCA may slow functional decline and increase survival in ALS patients. A multivariate analysis of the original TUDCA cohort demonstrated significant differences in the decline rate and survival time between the active treatment and placebo groups. These findings further support the disease-modifying effect of TUDCA and raise questions about combining it with sodium phenylbutyrate.

FRONTIERS IN NEUROLOGY (2023)

Review Medicine, General & Internal

Immunotherapy in Elderly Patients Affected by Non-Small Cell Lung Cancer: A Narrative Review

Michele Montrone, Gerardo Rosati, Vito Longo, Annamaria Catino, Raffaella Massafra, Annalisa Nardone, Francesco Pesola, Elisabetta Sara Montagna, Ilaria Marech, Pamela Pizzutilo, Domenico Galetta

Summary: Lung cancer is the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for 80% of cases. Immune checkpoint inhibitors (ICIs) have revolutionized the treatment of metastatic and early-stage NSCLC. However, the elderly face challenges in treatment due to comorbidities and reduced organ function. Despite less toxicity compared to chemotherapy, ICIs may be less effective in patients older than 75, possibly due to immunosenescence. This review explores the role of immunotherapy in elderly NSCLC patients, considering the biological aspects of immunosenescence.

JOURNAL OF CLINICAL MEDICINE (2023)

Article Oncology

Prevalence and predictors of infant and young child feeding practices in sub-Saharan Africa

Davide Ciardiello, Stefania Napolitano, Vincenzo Famiglietti, Lucia Esposito, Vincenzo De Falco, Alessandra Di Liello, Antonio Avallone, Evaristo Maiello, Filippo Pietrantonio, Chiara Cremolini, Maria Giulia Zampino, Nicola Fazio, Teresa Troiani, Erika Martinelli, Fortunato Ciardiello, Giulia Martini

Summary: Rechallenge with EGFR inhibitors is a promising strategy in refractory RAS/BRAF wild-type metastatic colorectal cancer (mCRC) patients. The presence of plasma ctDNA RAS/BRAF mutations at pretreatment liquid biopsy analysis was not associated with the length of anti-EGFR drug-free interval. Liquid biopsy can be used to select suitable patients for EGFR inhibitor rechallenge.

CANCERS (2023)

Article Oncology

KEYSTEP-008: phase II trial of pembrolizumab-based combination in MSI-H/dMMR metastatic colorectal cancer

Thierry Andre, Filippo Pietrantonio, Antonio Avallone, Mahmut Gumus, Lucjan Wyrwicz, Jong Gwang Kim, Suayib Yalcin, Mariusz Kwiatkowski, Sara Lonardi, Jakub Zolnierek, Amos Odeleye-Ajakaye, Pierre Leconte, David Fogelman, Tae Won Kim

Summary: Robust clinical activity has been observed with pembrolizumab in treating MSI-H/dMMR mCRC. However, there is still room for improvement in terms of response rate and progression-free survival. The KEYSTEP-008 trial aims to evaluate the efficacy and safety of pembrolizumab-based combination therapy compared with monotherapy in chemotherapy-refractory or previously untreated MSI-H/dMMR mCRC. Rating: 9/10

FUTURE ONCOLOGY (2023)

Article Health Care Sciences & Services

Bayesian Network Analysis for Prediction of Unplanned Hospital Readmissions of Cancer Patients with Breakthrough Cancer Pain and Complex Care Needs

Marco Cascella, Emanuela Racca, Anna Nappi, Sergio Coluccia, Sabatino Maione, Livio Luongo, Francesca Guida, Antonio Avallone, Arturo Cuomo

Summary: This study developed a data-driven prediction model for identifying cancer patients at a higher risk for unplanned hospital readmissions (HRAs). The results showed that nutritional support and radiotherapy were directly related to HRAs, while breakthrough cancer pain (BTcP) did not significantly affect readmissions.

HEALTHCARE (2022)

Review Biochemistry & Molecular Biology

Liquid Biopsy and Circulating Biomarkers for the Diagnosis of Precancerous and Cancerous Oral Lesions

Giuseppe Gattuso, Salvatore Crimi, Alessandro Lavoro, Roberta Rizzo, Giorgia Musumarra, Simona Gallo, Flavia Facciponte, Sabrina Paratore, Angela Russo, Roberto Bordonaro, Gaetano Isola, Alberto Bianchi, Massimo Libra, Luca Falzone

Summary: Liquid biopsy has emerged as a promising minimally invasive tool for the early detection and personalized treatment of oral cancer, by detecting circulating biomarkers. However, further studies are needed to clarify its clinical impact.

NON-CODING RNA (2022)

Article Health Policy & Services

Becoming an older caregiver: A study of gender differences in family caregiving at the end of life

Roberta Spatuzzi, Maria Velia Giulietti, Francesca Romito, Giorgio Reggiardo, Carmela Genovese, Michele Passarella, Letizia Raucci, Marcello Ricciuti, Fabiana Merico, Gerardo Rosati, Luigi Attademo, Anna Vespa

Summary: This study aimed to assess the burden experienced by older family caregivers who care for cancer patients at the end of their lives, and compare the differences according to gender. The results showed that older female caregivers are at a higher risk of burden and worse physical health compared to male caregivers. This highlights the need for further research on the role of gender differences in the experience of caregiving among older individuals in modern palliative care.

PALLIATIVE & SUPPORTIVE CARE (2022)

Article Social Work

Elderly Helping Other Elderly: A Comparative Study of Family Caregiver Burden Between Patients With Dementia or Cancer at the End of Life

Roberta Spatuzzi, Anna Vespa, Paolo Fabbietti, Marcello Ricciuti, Gerardo Rosati, Lorella Guariniello, Maria Antonietta Flavia Verrastro, Luigi Attademo, Maria Velia Giulietti

Summary: A new reality is being observed around the world as the population ages: family caregivers, who are themselves older adults helping their ill older relatives. This study assessed the burden of older family caregivers assisting older patients with dementia or cancer at the end-of-life. The findings suggest that elderly individuals helping those with Alzheimer's disease are at a higher risk of experiencing emotional burden compared to cancer caregivers.

JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE (2022)

No Data Available