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document
Comorbidity , age and overall survival in cetuximab-treated patients with advanced colorectal cancer ( ACRC ) -- results from NCIC CTG CO.17 : a phase III trial of cetuximab versus best supportive care . BACKGROUND the interplay between comorbidity , age and performance status ( PS ) as predictors of outcome in advanced colorectal cancer ( ACRC ) is poorly understood . We examined these factors as predictors of treatment toxicity and outcome in cetuximab-treated patients with ACRC . PATIENTS AND METHODS comorbidity was independently evaluated using the Charlson Comorbidity Index ( CCI ) , a validated measure of comorbidity based on the presence of medical conditions weighted according to their effect on mortality . CCI score was correlated with clinical and outcome data . RESULTS five hundred and seventy-two patients were included ; 41 % were ≥ 65 years and 25 % had comorbidities at randomization . In multivariate analysis ( MVA ) of all covariates , only older age was associated with greater comorbidity ( P = 0.008 ) . Overall survival ( OS ) was significantly better for patients with greater comorbidity in univariate analysis ( P = 0.047 ) . Conversely , better PS was associated with better OS in MVA ( hazard ratio 1.92 for PS = 2 versus PS = 0 , P < 0.0001 ) . Age was not associated with OS ( P = 0.13 ) . Elderly patients had significantly less grade ≥ 3 vomiting ( P = 0.034 ) but more dyspnea ( P = 0.005 ) . Patients with greater comorbidity had significantly less grade ≥ 3 vomiting ( P = 0.002 ) but more non-neutropenic fever ( P = 0.005 ) . CONCLUSION better PS was associated with improved OS . For patients with good PS , restricting cetuximab use in the setting of significant comorbidity does not appear justified .
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Intervention_Pharmacological
cetuximab-treated
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Intervention_Pharmacological
cetuximab
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Intervention_Physical
best supportive care
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Intervention_Pharmacological
cetuximab-treated
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Outcome_Physical
Comorbidity , age
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Outcome_Mortality
overall survival
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Outcome_Physical
comorbidity , age
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Outcome_Physical
performance status ( PS )
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Outcome_Physical
toxicity
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Outcome_Physical
Charlson Comorbidity Index ( CCI )
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Outcome_Physical
comorbidity
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Outcome_Physical
CCI score
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Participant_Condition
advanced colorectal cancer ( ACRC )
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Participant_Condition
cetuximab-treated patients
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Participant_Condition
ACRC
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Participant_Sample-size
five hundred and seventy-two patients
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Participant_Age
41 % were ≥ 65 years
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Participant_Age
Elderly patients