No Survival Benefit Seen for Young-Onset Metastatic Colorectal Cancer

MONDAY, Nov. 1, 2021 (HealthDay News) — For patients with metastatic colorectal cancer (mCRC), there is no survival benefit for young-onset CRC (yoCRC), according to a study published online Oct. 12 in the Journal of the National Cancer Institute.

Marla Lipsyc-Sharf, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues examined survival differences between younger and older patients with mCRC among 2,326 patients enrolled in a multicenter, randomized trial of first-line chemotherapy plus biologics. At study entry, 514 patients (22.1 percent) were younger than 50 years (yoCRC cohort).

The researchers found that overall survival did not differ significantly between yoCRC and older-onset patients (median, 27.07 versus 26.12 months; adjusted hazard ratio, 0.98; 95 percent confidence interval, 0.88 to 1.10; P = 0.78). In yoCRC and older patients, the median progression-free survival was also similar (10.87 versus 10.55 months; adjusted hazard ratio, 1.02; 95 percent confidence interval, 0.92 to 1.13; P = 0.67). The shortest overall survival was seen for patients younger than 35 years, with median overall survival of 21.95 months compared with 26.12 months in older-onset patients (adjusted hazard ratio, 1.08; 95 percent confidence interval, 0.81 to 1.44; P_trend = 0.93).

“Our data show no survival benefit for patients with yoCRC despite their having traditionally favorable baseline characteristics such as better performance status, more physical activity, and more left-sided primary tumors,” the authors write. “This may be due to diagnosis at more advanced stages, differences in underlying tumor biology as reflected in differences in molecular markers, or other, as-yet unidentified factors increasing disease aggression in these patients.”

Several authors disclosed financial ties to the pharmaceutical industry; pharmaceutical companies provided support for the study.

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