Authors:
Background:There are scant data regarding the diagnosis, treatment, and outcomes for mCRC pts diagnosed at a very young age ( < 30 yrs). We therefore explored age-related pt and tumor characteristics, treatment patterns and OS among mCRC pts treated in routine clinical practice.Methods:We retrospectively analyzed a national sample of pts ≥18 yrs old with confirmed mCRC diagnosed on or after 01/1/2014 (N = 10,990) using the Flatiron Health database. Descriptive statistics summarized pt and tumor characteristics and treatment patterns. Overall survival (OS) was indexed to mCRC diagnosis date. OS curves were estimated with Kaplan-Meier method. P-values were calculated for trend across all age groups.Results:Pt characteristics, mutation testing and 1st-line (1L) therapy trends differed significantly across age groups (results for < 30 and > 70 yrs age groups in Table). Median OS significantly differed by age, with a peak for those 40-49 yrs at diagnosis: 21.8 mos ( < 30 yrs), 21.0 mos (30-39 yrs), 27.5 mos (40-49 yrs), 26.5 mos (50-59 yrs), 22.3 mos (60-69 yrs), 15.8 mos ( > 70 yrs), p-value < 0.0001.Conclusions:1L treatment and OS for mCRC pts differed significantly by age at diagnosis in unadjusted analysis. Despite more often receiving 1L aggressive therapy (FOLFOX/FOLFIRI/FOLFOXIRI +/- ab), younger age groups had worse OS compared to all other age groups except > 70 yrs. Over-representation (compared to US 2010 census) of young African Americans supports earlier screening. Documentation of standard mutational testing significantly differed by age, and mutation positivity differed for BRAF. These findings suggest that a complex interplay between biologic, diagnostic and treatment factors may affect age- and race-based disparities in mCRC outcomes.
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ASCO Annual Meeting