内容紹介
The Efficacy and Safety of FOLFIRI or Combined FOLFIRI and Bevacizumab Treatment as Second-Line Chemotherapy for Metastatic Colorectal Cancer Patients Aged 75 Years and Older
Summary
The safety and efficacy of FOLFIRI as second-line chemotherapy for metastatic colorectal cancer patients aged≥75 years was retrospectively evaluated. We analyzed 106 patients, who received FOLFIRI or a combination of FOLFIRI and bevacizumab following oxaliplatin-based first-line chemotherapy. The clinical characteristics and outcome in elderly patients aged≥75 years(elderly[EP]group; n=18)were compared with those in patients aged<75 years(control group; n=88). The number of patients treated by a combination of FOLFIRI and bevacizumab in the EP group was lower than that in the control group(27.8% vs 55.7%;p=0.03). The comparison revealed no significant differences in response rate, progression-free survival, overall survival, and the frequency of overall adverse events after the start of second-line chemotherapy, although the frequency of anemia(≥grade 3, p=0.07)and alopecia(grade 1/2, p=0.054)tended to be higher in the EP group than in the control group. Although this study retrospectively analyzed a limited number of patients, our results indicate that the safety and efficacy of FOLFIRI as second-line chemotherapy for metastatic colorectal cancer are almost equal in patients aged≥75 years and those aged<75 years.
要旨
高齢者(75歳以上)の切除不能・再発大腸癌に対する二次治療としてのFOLFIRI療法の有効性と安全性について後方視的に検討した。オキサリプラチンベースの一次治療がfailureした後に,二次治療としてFOLFIRI(+bevacizumab)を導入した切除不能・再発大腸癌106例を対象に75歳以上18例(高齢群)と75歳未満88例(非高齢群)に分け,両群間の背景因子と治療成績を比較検討した。二次治療におけるbevacizumabの併用率は高齢群のほうが低かった(27.8% vs 55.7%,p=0.03)。奏効率(15.4% vs 13.6%,p>0.99),無増悪生存期間(中央値4.7か月vs 7.0か月,p=0.67),二次治療開始後全生存期間(中央値12.2か月vs 17.0か月,p=0.24)では両群間に有意差は認められなかった。有害事象の発生頻度も両群間に有意差はなかったが,高齢群のほうがgrade 1/2の脱毛(p=0.054)とgrade 3以上の赤血球減少の頻度(p=0.07)が高い傾向を認めた。少数での後方視的検討ではあるが,FOLFIRI(+bevacizumab)による二次治療は75歳以上の高齢者に対しても75歳未満とほぼ同等の有効性と安全性が得られることが示唆された。
目次
Summary
The safety and efficacy of FOLFIRI as second-line chemotherapy for metastatic colorectal cancer patients aged≥75 years was retrospectively evaluated. We analyzed 106 patients, who received FOLFIRI or a combination of FOLFIRI and bevacizumab following oxaliplatin-based first-line chemotherapy. The clinical characteristics and outcome in elderly patients aged≥75 years(elderly[EP]group; n=18)were compared with those in patients aged<75 years(control group; n=88). The number of patients treated by a combination of FOLFIRI and bevacizumab in the EP group was lower than that in the control group(27.8% vs 55.7%;p=0.03). The comparison revealed no significant differences in response rate, progression-free survival, overall survival, and the frequency of overall adverse events after the start of second-line chemotherapy, although the frequency of anemia(≥grade 3, p=0.07)and alopecia(grade 1/2, p=0.054)tended to be higher in the EP group than in the control group. Although this study retrospectively analyzed a limited number of patients, our results indicate that the safety and efficacy of FOLFIRI as second-line chemotherapy for metastatic colorectal cancer are almost equal in patients aged≥75 years and those aged<75 years.
要旨
高齢者(75歳以上)の切除不能・再発大腸癌に対する二次治療としてのFOLFIRI療法の有効性と安全性について後方視的に検討した。オキサリプラチンベースの一次治療がfailureした後に,二次治療としてFOLFIRI(+bevacizumab)を導入した切除不能・再発大腸癌106例を対象に75歳以上18例(高齢群)と75歳未満88例(非高齢群)に分け,両群間の背景因子と治療成績を比較検討した。二次治療におけるbevacizumabの併用率は高齢群のほうが低かった(27.8% vs 55.7%,p=0.03)。奏効率(15.4% vs 13.6%,p>0.99),無増悪生存期間(中央値4.7か月vs 7.0か月,p=0.67),二次治療開始後全生存期間(中央値12.2か月vs 17.0か月,p=0.24)では両群間に有意差は認められなかった。有害事象の発生頻度も両群間に有意差はなかったが,高齢群のほうがgrade 1/2の脱毛(p=0.054)とgrade 3以上の赤血球減少の頻度(p=0.07)が高い傾向を認めた。少数での後方視的検討ではあるが,FOLFIRI(+bevacizumab)による二次治療は75歳以上の高齢者に対しても75歳未満とほぼ同等の有効性と安全性が得られることが示唆された。