THE REVIEW OF THE CHEMOTHERAPY OF THE MORE THAN AND EQUAL TO 75-YEAR-OLD PATIENTS WITH UNRESECTABLE AND RECURRENT COLORECTAL CANCER, ESPECIALLY ABOUT THE POTENTIAL OF BEVCIZUMAB + DPD INHIBITOR

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Abstract

Introduction

Japan is hyper aging society with more than 20% of more than or equal to 65 years older people. The number of aging patients with unresectable and recurrent colorectal cancer (URCC) is increasing; however, the consensus of whether the chemotherapy is effecitive for these population especially 75 years older patients or specific treatment regimen is not confirmed. Therefore, we review the potential and str Bevacizumab + DPD inhibitor (BV/DPD-I) for the first-line treatment of URCC through our treatment experience for the 75 year older patients.

Patients

Twenty-six URCC patients treated by chemotherapy (male13/female, average age: 79.1 years) since January 2006.

Results

The treatment regimen (FOLFOX-based: 11/FOLFIRI-based: 3/Bevacizumab + DPD inhibitor (BV/DPD-I): 9 (S-1:5, UZEL/UFT: 4)/RPMI: 1/Per Oral:2 (S-1:1, Capecitabine:1) MST: 627 days, mPFS: 398 days, RR: 19.2% (CR0/PR5/SD29/PD1/NE1). ≥Grade 3 A.E.: BV/DPD-I:5.5% (sudden death: 1), other regimen:16.1% (sudden death:11). Though the significant difference of OS and PFS was not observed between BV-DPD-I and other regimens, however the rate of transition to second-line chemotherapy after first-line treatment after disease progressin is higher at BV/DPD-I (75%(3/4)) than at other regimens (30% (3/10)).

Conclusions

Prolonging survival by chemotherapy is possible to be obtained with hyper older patients with URCC as well as yaonger patients. Though the only specific adequate regimen was unclered, BV-DPD-I is suggested to be a candidate for the treatment choice of hyper older patients with URCC in view of 100% disease control rate, good feasibility and smooth transition to second-line chemotherapy.

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