Javier García-García

P-0234A RETROSPECTIVE ANALYSIS OF ADJUVANT CHEMOTHERAPY IN ELDERLY PATIENTS. EXPERIENCE OF OUR INSTITUTION

Background: The role of adjuvant chemotherapy in elderly patients has always been under discussion because of the lack of specific studies in these population and the scarce number of patients over 70 years old included in randomized clinical studies. Moreover, most of these patients have comorbidities that could increase toxicity and potentially reduce the long term benefit of adjuvant chemotherapy. The aim of this study is to retrospectively analyze the safety of adjuvant chemotherapy in elderly patients diagnosed of stage III colon cancer. Methods: Between July 2001 and November 2012, 46 patients (pts) aged 70 or more years underwent surgery for stage III colon cancer in our centre. Thirty (65%) were male and 16 (35%) were female. Median age was 76.5 (70-87). Adjuvant chemotherapy (CT) was administered in 37 (80.4%) pts. Results: Of those who received CT, 4 (10.8%) received FOLFOX, 13 (35.1%) received XELOX, 16 (43.2%) and received monotherapy with capecitabine. In the other four pts the scheme is unknown. Three pts were treated with a reduced dose because of comorbidities or performance status at diagnosis while 9 (24.3%) pts required dose reduction because of toxicity. However, only 5 (13.5%) pts did not complete the expected number of cycles. There were no deaths due to treatment. Only 3 (8.1%) pts had grade 3-4 hematologic toxicity. Of those receiving oxaliplatine, 30% experimented neurotoxicity grade 1-2 and one pt had an allergic reaction that required discontinuation of the treatment. One pt presented a deep vein thrombosis (grade 2). Three (8.1%) pts had erythrodysesthesia grade 3. 46% of pts had gastrointestinal toxicity but it was severe only in 2 (5.4%) pts. Relapse was detected in 7 (15.2%) pts; all of them had received adjuvant CT. At the time of analysis, median survival was 41.06 months for pts who received adjuvant CT and 25.85 for pts who did not. Conclusion: In our study adjuvant CT for elderly pts with colon cancer is safe and has the same profile of toxicity than in younger pts. However, there is an important amount of pts who did not received CT with the subsequent selection bias. More studies are needed to evaluate the special features in safety profile and the long term benefit of these therapies in this population.

P-0248OUTCOMES ACCORDING TO KRAS MUTATIONAL STATUS IN TREATMENT WITH CHEMOTHERAPY PLUS BEVACIZUMAB IN METASTATIC COLORECTAL CANCER

Background: Absence of KRAS mutations is a predictive factor of response to anti-EGFR agents in the treatment of metastatic colorectal cancer (mCRC) but it does not seem to be associated with Bevacizumab (Bv) treatment’s outcomes. The aim of this study is evaluate response, progression-free survival (PFS) and overall survival (OS) according to KRAS mutational status in patients (pts) with mCRC treated with CT plus Bv. Methods: It has carried out a retrospective study of 46 patients with mCRC who were treated at our institution between January 2004-December 2012 with Bv plus oxaliplatin or irinotecan based CT. PFS and OS times were estimated using Kaplan-Meier. Response Rates (RR) was analyzed with the Fisher’s test. Results: The median age of the patients was 62 years (33-77). 63% were men, and 37% were women. The Bv combination was based in oxaliplatin: 64.8% and based in irinotecan: 25.9%. 9.3% of pts received Bv plus Capecitabine in monotherapy. 75.9% of pts received Bv in first line of treatment. 52% of pts presented KRAS mutations (KRASmut) and 48% presented KRAS wild-type (KRASwt). No statisticallysignificant differences were found between the wild-type group and the mutated group in RR (KRASmut: 75% vs KRASwt: 86.4%; p= 0.445), or in median PFS survival (KRASmut: 12 months (m) (95% CI: 5.4-18.5) vs KRASwt: 10 m (95%CI: 7-13); p= 0.491) or in median OS (KRASmut: 47 m (95%CI: 14.6-65.3) vs KRASwt: 40m (95%CI: 15.8-64.2); p= 0.723). Conclusion: In our experience Bv is an effective treatment in mCRC irrespective of KRAS mutational status, with overall survival rates greater than orequal to 40 m. KRAS mutational status is not predictive of response to Bvor prognostic factor in our series.