Navigation Links
Chemotherapy combination outcomes differ for aged, younger colon cancer patients
Date:5/29/2009

ORLANDO, Fla.--The combination of chemotherapies 5FU and oxaliplatin compared to 5FU alone after surgery for colon cancer decreases colon cancer recurrence and promotes longer survival for patients under 70 -- but not for those who are older, according to Mayo Clinic and Dana-Farber Cancer Institute scientists who will present their findings at the American Society of Clinical Oncology's (ASCO) annual meeting in Orlando, Fla.

"By combining information about many patients from a collection of studies, our analysis determined that the more aggressive combination chemotherapy does not benefit older colon cancer patients as it does for those who are younger," said Nadine Jackson McCleary, MD, PhD, Dana-Farber gastrointestinal oncologist and the lead author on the study. Jackson-McCleary is the recipient of a 2008-2009 ASCO Young Investigator's Award.

The data (abstract 4010) will be presented on Saturday, May 30, 3 p.m. ET (Level 2, West Hall D2).

Adding oxaliplatin to chemotherapy treatment with 5FU reduces the risk of recurrence among patients less than 70 years of age who have had their primary cancer removed, the study determined, a finding that was expected based on the results of previous individual trials. Patients under 70 who were treated with 5FU and oxaliplatin had improved disease-free survival, with the addition of oxaliplatin relatively reducing the risk of recurrence or death by approximately 15 percent. Those patients aged 70 and older who were treated with the combined drug therapy, however, did not have improved outcomes compared to patients who received 5FU alone.

"We found that adding chemotherapy agents to the standard 5FU regimen in older patients after surgery did not provide the benefits that younger patients see," Dan Sargent, PhD, Mayo Clinic, a collaborator on the study, agreed. "For the older patient, this means that it is appropriate to choose the better tolerated treatment strategy of 5FU alone."

The benefit of post-surgical treatment for both young and older colon cancer patients with 5FU was documented in a 2001 New England Journal of Medicine study by Sargent and colleagues. By 2003, however, oxaliplatin was approved for use in combination with 5FU because the combination boosted the impact of 5FU on extending disease-free survival after colon cancer surgery. While the combined treatment carried additional risk of side effects, physicians prescribed the treatment strategy to patients of all ages. Initially, studies that examined age-related impact of the aggressive chemotherapy combination did not indicate a difference in survival or recurrence related to patient age.

The current study presented at the ASCO annual meeting includes a large enough patient base to powerfully discern differences related to age that are due to treatment regimen.

"The younger patients do get an additional boost from both drugs used together," Jackson McCleary noted. "Older patients don't benefit from that combination of treatment."

The findings arise from analysis of combined data collected within an expanded database by the Adjuvant Colon Cancer End Points (ACCENT) Group, a consortium of scientists. The ACCENT database includes data from more than 33,500 patients from the United States, Canada, Australia, and Europe. ACCENT is supported by the North Central Cancer Treatment Group (NCCTG); Sargent is chair of ACCENT.

"At this point we can only speculate as to why older patients do not benefit from combined chemotherapies," Jeffrey Meyerhardt, MD, MPH, of Dana-Farber and co-investigator on the trial said. "We do know that a higher number of older patients have to stop the drug before completing the full six month prescribed course of treatment."

"These studies add to the knowledge base that defines how to choose treatment strategies for every individual patient," Sargent said. "Age may become as important a consideration as tumor-specific factors when defining individual medical options for colorectal cancer patients."

Approximately half of all colon cancer patients are older than 70. While about half of the colon cancer patients over 70 will live for five years, those with recurrence typically develop additional tumors within three years. The disease is diagnosed in a million people worldwide every year. In the United States, colorectal cancer accounts for 10 percent of new cancer cases, as well as 10 percent of cancer-related deaths every year.


'/>"/>

Contact: Anne Doerr
anne_doerr@dfci.harvard.edu
440-670-6563
Dana-Farber Cancer Institute
Source:Eurekalert

Related medicine news :

1. Compliance and cost: Bitter pills to swallow in the age of oral chemotherapy
2. Rexin-G Controls Tumor Growth and Improves Survival in Chemotherapy-Resistant Sarcoma and Osteosarcoma: Phase I/II and Phase II Studies, ASCO 2009
3. Study shows chemotherapy improves survival among older breast cancer patients
4. Chemotherapy Superior to New Drug for Early Breast Cancer
5. Retrospective Analysis Finds Treatment of Cancer Chemotherapy Patients With Epoetin Alfa Associated With Lower Drug Cost Than Darbepoetin Alfa
6. 3-drug chemotherapy combination increases organ preservation in patients with larynx cancer
7. Scientists trial device to treat chemotherapy-related nausea
8. Lung Cancer Microscopic Appearance Affects Response to Chemotherapy
9. Sequential and alternating chemotherapy and radiation equally effective in larynx cancer therapy
10. How chemotherapy drugs block blood vessel growth, slow cancer spread
11. UNC study supports role of circadian clock in response to chemotherapy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... ... ... Vail knee specialist Robert LaPrade, MD, PhD was named one ... consists of physicians establishing, leading and partnering with ambulatory surgery centers across the United ... Center, also known as an ASC, is a modern health care facility focused on ...
(Date:2/12/2016)... ... 12, 2016 , ... Donor Network West, the organ procurement organization that heals ... with San Ramon Regional Medical Center. Under the collaboration, the first of its kind, ... accommodate a more certain time frame for donor families for the recovery of organs. ...
(Date:2/12/2016)... TX (PRWEB) , ... February 12, 2016 , ... ... of southwest Houston and surrounding communities by continuing it’s commitment to act as ... Family Promise. The organization works closely with area homeless families to fulfill immediate ...
(Date:2/12/2016)... ... 12, 2016 , ... Atlantic Information Services, Inc. (AIS) is ... an upcoming Feb. 24 webinar that will discuss ways health plans and PBMs ... as the $1,000-per-pill hepatitis C treatment Sovaldi and high-cost PCSK9 inhibitors to treat ...
(Date:2/12/2016)... Ranch, Colo. (PRWEB) , ... February 12, 2016 , ... ... over the past 35 years. A president has access to health and wellness resources ... of the free world, no single individual has a schedule as frenetic as the ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... -- Kindred Biosciences, Inc. (NASDAQ: KIN ), a biopharmaceutical ... pets, today announced the submission to FDA of the ... (NADA) for Zimeta™ (dipyrone injection, KIND-012).  Positive topline results ... the control of pyrexia (fever) in horses were recently ... --> The Chemistry, Manufacturing, and Controls technical ...
(Date:2/11/2016)... SAN FRANCISCO , Feb. 11, 2016 Potrero ... system, is pleased to announce the appointment of George ... San Antonio, TX , WellMed is ... servicing over 200,000 patients and HMO members in ... founding WellMed in 1990 out of his own internal medicine ...
(Date:2/11/2016)... , Feb. 11, 2016  AfterPill.com is reporting that ... alcohol abstinence for all women who are at risk ... U.S. each year and raises the risks of unprotected ... --> According to the Guttmacher Institute, there ... women of child-bearing age, who have sex without the ...
Breaking Medicine Technology: