The proportion of older patients with comorbidities receiving treatment for metastatic colorectal cancer (mCRC) has increased over the last 2 decades despite the overall percentage of older adults being treated remaining low, a study published in the journal Cancer has shown.1
Although the treatment of mCRC has drastically changed in the last 20 years, there are limited data on the impact of age and comorbidities on the receipt of chemotherapy. Therefore, researchers at Fox Chase Cancer Center in Philadelphia, Pennsylvania, sought to assess the rate of chemotherapy adoption among commercially insured older adults with or without comorbidities.
For the study, investigators analyzed data from 16,087 patients with mCRC treated with 5-fluorouracil-based chemotherapy between 1995 and 2009 included in the LifeLink Health Plan Claims Database. Patients were classified as being older (older than 70 years) and younger (70 years or younger).
Results showed that 24% of patients who received chemotherapy were older than 70 years.
In regard to comorbidities, researchers found that the percentage of patients with a Charlson Comorbidity Index (CCI) greater than 1 increased from 14% in 1996 to 40% after 2004 (P <.05); however, older patients were less likely to receive chemotherapy with more than 2 agents compared with younger patients both in 2003 and 2009 (P <.001).
Furthermore, after the approval of irinotecan by the US Food and Drug Administration in 1998, the use of irinotecan was lower among older adults but there was no difference in use by 2002 (P =.9).
After adjusting for multiple factors, the study also demonstrated that older age and a CCI greater than 1 were significantly associated with a lower likelihood of receiving combination chemotherapy (both P <.001).
1. Vijayvergia N, Li T, Wong YN, Hall MJ, Cohen SJ, Dotan E. Chemotherapy use and adoption of new agents is affected by age and comorbidities in patients with metastatic colorectal cancer. Cancer. 2016 Jul 5. doi: 10.1002/cncr.30077. [Epub ahead of print]