Systemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials.

Détails

Ressource 1Télécharger: s12885-017-3266-9.pdf (645.45 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_C96188F64686
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Systemic therapy in younger and elderly patients with advanced biliary cancer: sub-analysis of ABC-02 and twelve other prospective trials.
Périodique
BMC cancer
Auteur(s)
McNamara M.G., Bridgewater J., Lopes A., Wasan H., Malka D., Jensen L.H., Okusaka T., Knox J.J., Wagner D., Cunningham D., Shannon J., Goldstein D., Moehler M., Bekaii-Saab T., Valle J.W.
ISSN
1471-2407 (Electronic)
ISSN-L
1471-2407
Statut éditorial
Publié
Date de publication
12/04/2017
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
262
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Outcomes in younger (<40 years) and elderly (≥70 years) patients with advanced biliary cancer (ABC) receiving palliative chemotherapy are unclear. This study assessed outcomes in those receiving monotherapy or combination therapy in thirteen prospective systemic-therapy trials.
Multivariable analysis explored the impact of therapy on progression-free (PFS) and overall survival (OS) in two separate age cohort groups: <70 years and ≥70 years, and <40 years and ≥40 years.
Overall, 1163 patients were recruited (Jan 1997-Dec 2013). Median age of entire cohort: 63 years (range 23-85); 36 (3%) were <40, 260 (22%); ≥70. Combination therapy was platinum-based in nine studies. Among patients <40 and ≥70 years, 23 (64%) and 182 (70%) received combination therapy, respectively. Median follow-up was 42 months (95%-CI 37-51). Median PFS for patients <40 and ≥40 years was 3.5 and 5.9 months (P = 0.12), and OS was 10.8 and 9.7 months, respectively (P = 0.55). Median PFS for those <70 and ≥70 years was 6.0 and 5.0 months (P = 0.53), and OS was 10.2 and 8.8 months, respectively (P = 0.08). For the entire cohort, PFS and OS were significantly better in those receiving combination therapy: Hazard Ratio [HR]-0.66, 95%-CI 0.58-0.76, P < 0.0001 and HR-0.72, 95%-CI 0.63-0.82, P < 0.0001, respectively; and in patients ≥70 years: HR-0.54 (95%-CI 0.38-0.77, P = 0.001) and HR-0.60 (95%-CI 0.43-0.85, P = 0.004), respectively. There was no evidence of interaction between age and treatment for PFS (P = 0.58, P = 0.66) or OS (P = 0.18, P = 0.75).
In ABC, younger patients are rare, and survival in elderly patients in receipt of systemic therapy for advanced disease, whether monotherapy or combination therapy, is similar to that of non-elderly patients, therefore age alone should not influence decisions regarding treatment.

Pubmed
Web of science
Open Access
Oui
Création de la notice
28/04/2017 10:05
Dernière modification de la notice
20/08/2019 16:44
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