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Randomized Controlled Trial Multicenter Study
Observed benefit and safety of aflibercept in elderly patients with metastatic colorectal cancer: An age-based analysis from the randomized placebo-controlled phase III VELOUR trial.
- Paul Ruff, Eric Van Cutsem, Radek Lakomy, Jana Prausova, Guy A van Hazel, Vladimir M Moiseyenko, Karen Soussan-Lazard, Emmanuelle Dochy, Emmanuelle Magherini, Teresa Macarulla, and Demetris Papamichael.
- University of Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa. Electronic address: pruff@iafrica.com.
- J Geriatr Oncol. 2018 Jan 1; 9 (1): 32-39.
ObjectivesAflibercept (ziv-aflibercept) significantly improves progression-free (PFS) and overall survival (OS) when added to 5-fluorouracil, leucovorin and irinotecan (FOLFIRI), compared with FOLFIRI alone, in patients with metastatic colorectal cancer previously treated with oxaliplatin-based therapy. This subset analysis of the VELOUR study investigates aflibercept plus FOLFIRI versus placebo plus FOLFIRI according to age.MethodsEfficacy and safety were analyzed by treatment arm and age (≥ or <65years).ResultsOverall, 443 patients were ≥65years old (205 in aflibercept arm; 238 in placebo arm) and 783 were <65years old (407 in aflibercept arm; 376 in placebo arm). Median OS was 12.6 versus 11.3months (hazard ratio [HR]: 0.85; 95.34% CI 0.68-1.07) in patients ≥65years old and 14.5 versus 12.5months (HR: 0.80; 95.34% CI 0.67-0.95) in those patients <65years old, for patients receiving FOLFIRI plus aflibercept or placebo, respectively. There was no interaction between treatment and age. Treatment-emergent adverse events (AEs) were comparable for patients <65years and ≥65years old. The incidence of grade 3/4 AEs was higher for patients ≥65years old than for those <65years old in both the aflibercept (89.3% versus 80.5%) and placebo (67.4% versus 59.4%) arms. Interaction tests for grade 3/4 antiangiogenic agent-related AEs suggested no heterogeneity between the older and younger patient populations (p>0.1).ConclusionA limited but consistent benefit on both OS and PFS was associated with the addition of aflibercept to FOLFIRI compared with placebo in patients <65 and ≥65years old, with a marked but manageable increase in the toxicity profile in older patients.Trial Registrationclinicaltrials.govNCT00561470.Copyright © 2017 Elsevier Inc. All rights reserved.
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