Geriatric factors analyses from FFCD 2001-02 phase III study of first-line chemotherapy for elderly metastatic colorectal cancer patients.
Several predictors of metastatic colorectal cancer (mCRC) outcomes have been described. Specific geriatric characteristics could be of interest to determine prognosis.



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).



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 mm3and carcinoembryonic antigen >2N. There was a trend towards better OS in patients with normal IADL.



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.
Gastroenterology Department, CHU Saint Louis, APHP, Université Paris 7, Sorbonne Paris Cité, Paris, France. Electronic address: thomas.aparicio@aphp.fr.
Thomas
T
Aparicio
Gastroenterology Department, CH Blois, Blois, France. Electronic address: dgargot@ch-blois.fr.
Dany
D
Gargot
Geriatric Department, CHU Sainte Perine, APHP, Versailles Saint-Quentin University, Paris, France. Electronic address: laurent.teillet@aphp.fr.
Laurent
L
Teillet
Statistics Department, Fédération Francophone de Cancérologie Digestive (FFCD), Dijon, France. Electronic address: emilie.maillard@u-bourgogne.fr.
Emilie
E
Maillard
Oncology Department, Clinique Chénieux, Limoges, France.
Dominique
D
Genet
CH Oncogard, Alès, France. Electronic address: cretinjacques@yahoo.fr.
Jacques
J
Cretin
Gastroenterology Department, CH Meaux, Meaux, France. Electronic address: c-locher@ch-meaux.fr.
Christophe
C
Locher
Gastroenterology Department, CHU Robert Debré, Reims, France. Electronic address: obouche@chu-reims.fr.
Olivier
O
Bouché
Gastroenterology Department, CH Pasteur, Colmar, France. Electronic address: gilles.breysacher@ch-colmar.fr.
Gilles
G
Breysacher
Digestive Oncology and Gastroenterology Department, CHU La Timone, APHM, Aix-Marseille University, Marseille, France. Electronic address: Jean-francois.seitz@ap-hm.fr.
Jean-François
JF
Seitz
Gastroenterology Department, CHU Hôpital Nord, Marseille, France. Electronic address: mohamed.gasmi@ap-hm.fr.
Mohamed
M
Gasmi
Oncology Department, CH Annecy Genevois, Pringy, France. Electronic address: lstefani@ch-annecygenevois.fr.
Laetitia
L
Stefani
Gastroenterology Department, CH Béziers, Béziers, France. Electronic address: mohamed.ramdani@ch-beziers.fr.
Mohamed
M
Ramdani
Gastroenterology Department, CHU Trousseau, Tours, France. Electronic address: thierry.lecomte@univ-tours.fr.
Thierry
T
Lecomte
Gastroenterology Department, CH de Mont de Marsan, Mont de Marsan, France. Electronic address: dominique.auby@ch-mt-marsan.fr.
Dominique
D
Auby
Gastroenterology Department, CH de la Roche sur Yon, La Roche sur Yon, France. Electronic address: roger.faroux@chd-vendee.fr.
Roger
R
Faroux
Sorbonne University, UPMC Gastroenterology Department, CHU Pitié-Salpétrière, APHP, Paris, France. Electronic address: jean-baptiste.bachet@psl.aphp.fr.
Jean-Baptiste
JB
Bachet
Gastroenterology Department, CHU Ambroise Paré, APHP, Boulogne, France. Electronic address: celine.lepere@egp.aphp.fr.
Céline
C
Lepère
Gastroenterology Department, CH Saint Jean, Perpignan, France. Electronic address: faiza.khemissa@ch-perpignan.fr.
Faiza
F
Khemissa
Gastroenterology Department, CHU Henri Mondor, APHP, Créteil, France. Electronic address: iradj.sobhani@aphp.fr.
Iradj
I
Sobhani
Oncology Department, CH Avignon, Avignon, France. Electronic address: OBoulat@ch-avignon.fr.
Olivier
O
Boulat
Oncology Department, Institut Curie, Saint-Cloud, France. Electronic address: emmanuel.mitry@uvsq.fr.
Emmanuel
E
Mitry
CHU Le Bocage and INSERM U866 Dijon, France. Electronic address: jean-louis.jouve@chu-dijon.fr.
Jean-Louis
JL
Jouve
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D015577:Geriatric Assessment; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin
Colorectal cancer; Elderly; Geriatric assessment; Irinotecan; Prognostic factors