Medical Technology

Survival is the same for Older and Younger Patients suffering from Mets CRC

According to an extensive study in a phase 3 randomized study, overall survival (OS), and progression-free survival are very similar in patients with metastatic colorectal carcinoma (CRC).

“Colorectal cancer is predicted to become the most common cause of death from cancer among patients 20 to 49 in 2040. Therefore, it is crucial to know the survival rate in this group,” lead author Marla Lipsyc-Sharf, MD Young-Onset Colorectal Cancer Center, Dana-Farber Cancer Center, Boston, Massachusetts, told Medscape Medical Newsin an email. Our study confirms that young-onset colorectal cancer survival rates aren’t significantly different from those of older patients. This is an important lesson for oncologists.

Previous studies looking at the survival of younger and older patients with metastatic CRC produced contradictory results. Lipsyc-Sharf and colleagues set out to improve the literature in their extensive randomized study, which was published online on the 21st of October in the Journal of the National Cancer Institute.

Lipsyc-Sharf and his colleagues have enrolled 2236 patients into the Cancer and Leukemia Group B/SWOG 80405 Alliance trial to assess the safety and efficacy of chemotherapy plus a biologic treatment for metastatic CRC. About 22% of participants (524 patients) were younger than 50 at study enrollment with a median age of about 44. The remaining 78% (1812 patients) were 50 years old or older at the time of enrollment, and had a a median age of 62.5.

OS was the main outcome. Other outcomes included PFS. This is defined as the period between the study’s beginning and progression of disease or death. At a follow-up time of 6 years, the median OS was 27.07 months in the younger CRC cohort compared to 26.12 months in the older CRC cohort.

Similar to the median PFS, median PFS for both younger and older groups was almost identical, at 10.87 months and 10.55 months and 10.55 months, respectively. Patients younger than 35 did have a shorter median OS of 21.95 months and PFS of 9.33 months compared to 26.12 months and 10.55 months, respectively, for those 50 and over however, neither of the differences was significant.

The authors point out that the OS of patients who have metastatic cancer is the same for younger and older patients. This is due to the fact that younger patients have done better than their counterparts who are older. Younger patients are more likely to be healthier overall (less diabetes, and more physical activity), more left-sided CRC (which is associated with better prognosis), and receive more intensive therapy.

Lipsyc-Sharf stated that it’s not clear why CRC with onset in the young age patients, despite having better characteristics and characteristics, did not have an better survival rate than older patients.

According to the authors, this could be due to the fact that younger patients are more likely to be diagnosed with CRC in advanced stages. This could be due to differences in the tumor biology or other unidentified factors. However, “additional investigation into the tumor anatomy, clinical characteristics, and the most effective treatment for patients with [early onset] CRC is essential,” the authors conclude.

The National Cancer Institute of National Institutes of Health has backed the study. In part, Genentech, Sanofi, Bristol Myers Squibb and Genentech contributed to the funding. Lipsyc-Sharf has reported no relevant financial relationships.

J Natl Cancer Inst. Online October 21 2021. Abstract

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