Nikolic-Tomasevic, et al. 2000 (2020. Nikolic-Tomasevic Z, Jelic S, Popov I, Radosavljevic D. Colorectal cancer: dilemmas regarding patient selection and toxicity prediction.J Chemother. 2000;12(3):244-51, http://dx.doi.org/10.1179/joc.2000.12.3.244. http://dx.doi.org/10.1179/joc.2000.12.3....
) |
16 |
25 (4) |
Retrospective |
Second-line irinotecan |
NR |
Partial response, 20%; stable disease, 46.6% |
Massacesi, et al. 2002 (1616. Massacesi C, Pistilli B, Valeri M, Lippe P, Rocchi MB, Cellerino R, et al. Predictors of short-term survival and progression to chemotherapy in patients with advanced colorectal cancer treated with 5-fluorouracil-based regimens.Am J Clin Oncol. 2002;25(2):140-8, http://dx.doi.org/10.1097/00000421-200204000-00008. http://dx.doi.org/10.1097/00000421-20020...
) |
321 |
8 (26) |
Retrospective |
Various |
15 |
Right and transverse colon primary tumors, younger age, ECOG PS ≥ 2, elevated CEA ≥ 5 g/l, site of metastatic disease and progression to first-line CT were associated with short-term survival; the median PFS in all treated in first-line CT = 5 m. |
Benavides, et al. 2004 (1818. Benavides M, García-Alfonso P, Cobo M, Muãoz-Martín A, Gil-Calle S, Carabantes F, et al. Weekly irinotecan (CPT-11) in 5-FU heavily pretreated and poor-performance-status patients with advanced colorectal cancer.Med Oncol. 2004;21(3):255-62, http://dx.doi.org/10.1385/MO:21:3:255. http://dx.doi.org/10.1385/MO:21:3:255...
) |
34 |
76.5 (26) |
Phase II, single-arm |
Second- or subsequent-line weekly irinotecan |
8.3 |
Time to disease progression, 5.5 m (range, 0.9-17.5 m) |
Sørbye, et al. 2007 (1717. Sørbye H, Berglund A, Tveit KM, Ogreid D, Wanderås EH, Wentzel-Larsen T, et al. Secondary treatment and predictive factors for second-line chemotherapy after first-line oxaliplatin-based therapy in metastatic colorectal cancer.Acta Oncol. 2007;46(7):982-8, http://dx.doi.org/10.1080/02841860701261568. http://dx.doi.org/10.1080/02841860701261...
) |
112 |
14 (15) |
Retrospective |
FLIRI, FOLFIRI, CAPIRI |
First-line - 8.9 Second-line - 20.8 |
More chance to receive second-line CT in ECOG PS < 2 (OR = 7.5) and alkaline phosphatase < 300 IU/L (OR = 2.5); OS = 1.7 m pts did not receive second-line irinotecan due poor PS; OS = 9.5 m and PFS = 4.1 m after beginning second-line irinotecan-based CT. |
Shitara, et al. 2008 (1414. Shitara K, Munakata M, Kasai M, Muto O, Sakata Y. Prolongation of survival and improvement in performance status following palliative chemotherapy in gastrointestinal cancer patients with a poor performance status.Oncology. 2008;74(3-4):135-42, http://dx.doi.org/10.1159/000151360. http://dx.doi.org/10.1159/000151360...
) |
116 |
27.6 (32) |
Retrospective |
Various |
2.2 |
32.7% of pts achieved a tumor response, decreased fluid accumulation (ascites and pleural effusion) or decreased in tumor markers; PS improvement = 13.8% |
Nannini, et al. 2009 (4949. Nannini M, Nobili E, Di Cicilia R, Brandi G, Maleddu A, Pantaleo MA, et al. To widen the setting of cancer patients who could benefit from metronomic capecitabine.Cancer Chemother Pharmacol. 2009;64(1):189-93, http://dx.doi.org/10.1007/s00280-009-0930-z. http://dx.doi.org/10.1007/s00280-009-093...
) |
3 |
66 (2) |
Case series |
Metronomic capecitabine |
NR |
Treatment was well tolerated, and pts achieved long-term disease control for 6 and 15 cycles. |
Sargent, et al. 2009 (66. Sargent DJ, Köhne CH, Sanoff HK, Bot BM, Seymour MT, de Gramont A, et al. Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer.J Clin Oncol. 2009;27(12):1948-55, http://dx.doi.org/10.1200/JCO.2008.20.2879. http://dx.doi.org/10.1200/JCO.2008.20.28...
) |
6286 |
8.09 (509) |
Meta-analysis |
Various |
8.5 |
Median PFS = 7.6 vs. 4.9 months (ECOG PS < 2 vs. 2; HR = 1.52); grade > 2 nausea = 8.5% vs. 16.4% (ECOG PS < 2 vs. 2) and vomiting = 7.6% vs. 11.9% (ECOG PS < 2 vs. 2); 60-day all-cause mortality = 2.8% vs. 12.0% (ECOG PS < 2 vs. 2). |
Sørbye, et al. 2009 (1515. Sorbye H, Pfeiffer P, Cavalli-Björkman N, Qvortrup C, Holsen MH, Wentzel-Larsen T, et al. Clinical trial enrollment, patient characteristics, and survival differences in prospectively registered metastatic colorectal cancer patients.Cancer. 2009;115(20):4679-87, http://dx.doi.org/10.1002/cncr.24527. http://dx.doi.org/10.1002/cncr.24527...
) |
760 |
17 (79) |
Prospective observational |
Various |
15.8 (CT)2.8 (BSC) |
36% of pts receiving CT were included in trials, and 32% received BSC alone.Trial-treated pts had a median OS of 21.3 m, and non-trial-treated pts had a median OS of 15.2 m; BSC was used because pts with poor PS had a median OS = 2.1 m. |
Shitara, et al. 2010 (88. Shitara K, Yokota T, Takahari D, Shibata T, Sato Y, Tajika M, et al. Cetuximab plus FOLFOX for Patients with Metastatic Colorectal Cancer with Poor Performance Status and/or Severe Tumor-Related Complications.Case Rep Oncol. 2010;3(2):282-6, http://dx.doi.org/10.1159/000319474. http://dx.doi.org/10.1159/000319474...
) |
8 |
87.5 (7) |
Case series |
FOLFOX + cetuximab |
5.2 |
6 of 8 pts (75%) had clinical/radiological improvement. |
Naeim, et al. 2013 (1212. Naeim A, Ward PR, Wang HJ, Dichmann R, Liem AK, Chan D, et al. A phase II trial of frontline capecitabine and bevacizumab in poor performance status and/or elderly patients with metastatic colorectal cancer.J Geriatr Oncol. 2013;4(4):302-9, http://dx.doi.org/10.1016/j.jgo.2013.05.001. http://dx.doi.org/10.1016/j.jgo.2013.05....
) |
45 |
62.2 (28) |
Phase II, single-arm, |
Capecitabine and bevacizumab |
12.7 |
Median PFS = 6.87 m; ORR = 35% (16 pts) Grade 3-4 toxicities = 13.3-17.8% |
Sgouros, et al. 2013 (1919. Sgouros J, Aravantinos G, Dragasis S, Koutsounas K, Antoniou G, Belechri M, et al. Reintroduction of irinotecan and oxaliplatin as a combination (IROX regimen) in heavily pretreated colorectal cancer patients - A single-center experience.Forum Clin Oncol. 2013; 4(3):13-18.) |
25 |
8 (2) |
Retrospective |
IROX |
7 |
Disease control rate = 32%; median of 3 previous treatments (range, 2-7); median PFS = 3 m (95% CI, 2.3-3.7) |
Jehn, et al. 2014 (1111. Jehn CF, BöningL, Kröning H, Pezzutto A, Lüftner D. Influence of comorbidity, age and performance status on treatment efficacy and safety of cetuximab plus irinotecan in irinotecan-refractory elderly patients with metastatic colorectal cancer.Eur J Cancer. 2014;50(7):1269-75, http://dx.doi.org/10.1016/j.ejca.2014.01.005. http://dx.doi.org/10.1016/j.ejca.2014.01...
) |
497 |
22.9 (114) |
Retrospective |
Cetuximab and irinotecan |
NR |
Median PFS = 5.9 vs. 6.1 m (Age < 65 vs. > 65 years) PS had a negative impact on PFS (HR = 0,499; 95% CI, 0.34-0.72) |
Wheatley-Price, et al. 2014 (2121. Wheatley-Price P, Ali M, Balchin K, Spencer J, Fitzgibbon E, Cripps C. The role of palliative chemotherapy in hospitalized patients.Curr Oncol. 2014;21(4):187-92, http://dx.doi.org/10.3747/co.21.1989. http://dx.doi.org/10.3747/co.21.1989...
) |
199 |
9 (18) |
Retrospective |
Various |
4.5 |
6 m survival rate = 41%; 77% of the treated inpatients were discharged home, and 72% received further CT. |
Zheng, et al. 2014 (5050. Zheng Z, Hanna N, Onukwugha E, Reese ES, Seal B, Mullins CD. Does the type of first-line regimens influence the receipt of second-line chemotherapy treatment? An analysis of 3211 metastatic colon cancer patients.Cancer Med. 2014;3(1):124-33, http://dx.doi.org/10.1002/cam4.176. http://dx.doi.org/10.1002/cam4.176...
) |
7951 |
9.3 (742) * proxy for poor PS |
Retrospective |
5-FU + LV/IROX/IROX + biologics/Oxaliplatin + biologics |
|
Pts with a proxy for poor performance were less likely to receive second-line treatment (HR = 0.82, P < 0.01) |
Carter, et al. 2015 (99. Carter GC, Landsman-Blumberg PB, Johnson BH, Juneau P, Nicol SJ, Li L, et al. KRAS testing of patients with metastatic colorectal cancer in a community-based oncology setting: a retrospective database analysis.J Exp Clin Cancer Res. 2015;34:29, http://dx.doi.org/10.1186/s13046-015-0146-5. http://dx.doi.org/10.1186/s13046-015-014...
) |
1363 |
20.1 (274) |
Retrospective |
NR |
|
KRAS testing was more frequent if pts presented with lung metastases, poor PS, more comorbidities, and mCRC diagnosis after 2009. |
Crosara Teixeira, et al. 2015 (77. Crosara Teixeira M, Marques DF, Ferrari AC, Alves MF, Alex AK, Sabbaga J, et al. The effects of palliative chemotherapy in metastatic colorectal cancer patients with an ECOG performance status of 3 and 4.Clin Colorectal Cancer. 2015;14(1):52-7, http://dx.doi.org/10.1016/j.clcc.2014.09.010. http://dx.doi.org/10.1016/j.clcc.2014.09...
) |
240 |
58.3 (140) |
Retrospective |
FLOX, FOLFOX, 5-FU |
ECOG PS 2 = 10.8 ECOG PS 3-4 = 6.8 |
The median OS was longer in pts with ECOG PS > 2 treated with chemotherapy vs. those treated with BSC alone (6.8 vs. 2.3 months, P = 0.13).OS was shorter in pts with ECOG PS 2 than in those with ECOG PS 0-1 (HR = 1.67). |
Grande, et al. 2016 (1313. Grande R, Natoli C, Ciancola F, Gemma D, Pellegrino A, Pavese I, et al. Treatment of Metastatic Colorectal Cancer Patients ≥75 Years Old in Clinical Practice: A Multicenter Analysis.PLoS One. 2016;11(7):e0157751, http://dx.doi.org/10.1371/journal.pone.0157751. http://dx.doi.org/10.1371/journal.pone.0...
) |
751 |
14.6 (110) |
Retrospective |
Various |
17 |
Not treated = median of 5 m Treated = median of 20 m |
Ho, et al. 2016 (1010. Ho MY, Renouf DJ, Cheung WY, Lim HJ, Speers CH, ZhouC, et al. Patterns of practice with third-line anti-EGFR antibody for metastatic colorectal cancer.Curr Oncol. 2016;23(5):329-33, http://dx.doi.org/10.3747/co.23.3030. http://dx.doi.org/10.3747/co.23.3030...
) |
443 |
?? |
Prospective observational |
FOLFOX, FOLFIRI |
22.3 |
The main reasons that KRAS wt pts did not receive anti-EGFR therapy were poor PS and death. |