Toxicity and antitumor activity of novel agents in elderly patients with cancer included in phase 1 studies.


Journal

Investigational new drugs
ISSN: 1573-0646
Titre abrégé: Invest New Drugs
Pays: United States
ID NLM: 8309330

Informations de publication

Date de publication:
12 2021
Historique:
received: 01 05 2021
accepted: 12 07 2021
pubmed: 22 7 2021
medline: 17 2 2022
entrez: 21 7 2021
Statut: ppublish

Résumé

Introduction The number of cancer cases among the elderly continue to increase as the worldwide population ages. This patient subset is underrepresented in clinical trials, partly because of unresolved uncertainties about age-associated tolerabilities and antitumor activities. We reviewed phase 1 trial data to study tolerance and efficacy of novel agents used for treatment of elderly patients with cancer. Methods Data from 773 consecutive evaluable patients in 85 phase 1 clinical trials (2008-2016) at START Madrid-CIOCC were analyzed according to age, with respect to objective response, survival, and toxicity. Results The mean age was 58.7 (range: 18-87) years; 260 (33.6%) patients were >65 y (elderly group). One hundred thirty-seven (17.8%) patients received immunotherapy drugs, 308 (39.8%) received targeted agents, and 328 (42.4%) received chemotherapy. No statistically significant differences in overall survival, objective response, or severe toxicity rates were found according to treatment type. Similar toxicities and clinical activities were found between the two age subgroups; 18.8% of the elderly and 20.7% of the younger patients experienced severe hematological toxicity (p=0.5), and 30.2% and 32.7%, respectively, experienced severe non-hematological toxicity (p=0.4). Regarding antitumor activity, 12.4% of the elderly and 15% of the younger patients achieved objective responses (p=0.41). There were no significant between-group differences in overall survival (9.7 versus 11.5 months, respectively, p=0.1) or progression-free survival (2.3 versus 2.2 months, respectively, p=0.7). Conclusions This retrospective study found that elderly and younger populations had comparable antitumor activities and toxicity profiles. These results support including elderly patients with cancer in early-phase trials.

Identifiants

pubmed: 34287771
doi: 10.1007/s10637-021-01150-1
pii: 10.1007/s10637-021-01150-1
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1694-1701

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Geriletu Ao (G)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

Maria de Miguel (M)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

Ana Gomes (A)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

Runhan Liu (R)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

Valentina Boni (V)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

Irene Moreno (I)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain.

José Miguel Cárdenas (JM)

Departamento de Matemática Aplicada y Estadística, San Pablo CEU University. Calle Julián Romea, 18. 28003, Madrid, Spain.

Antonio Cubillo (A)

Centro Integral, Oncológico Clara Campal. Hospital Universitario HM Sanchinarro. Calle Oña, 10. 28050, Madrid, Spain.
Facultad de Medicina, Departamento de Ciencias Médicas Clínicas, Universidad CEU San Pablo. Plaza Montepríncipe, 1D, 28668, Alcorcón, Madrid, Spain.

Lisardo Ugidos (L)

Centro Integral, Oncológico Clara Campal. Hospital Universitario HM Sanchinarro. Calle Oña, 10. 28050, Madrid, Spain.

Emiliano Calvo (E)

START Madrid-HM CIOCC, Centro Integral Oncológico Clara Campal, Hospital Universitario HM Sanchinarro, Calle Oña, 10. 28050, Madrid, Spain. emiliano.calvo@startmadrid.com.

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