GI and gynaecological tumours in the elderly

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Published: 22 Nov 2016
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Dr Demetris Papamichael - Cyprus Oncology Centre, Strovolos, Cyprus

Dr Papamichael speaks with ecancertv at SIOG 2016 about GI and gynaecological tumours in the elderly, and the use of cetuximab in colorectal cancer.

He discusses the processes of retrieving the most important phase III trail data, where elderly patients received cetuximab. 

Finally, he gives us an insight into the aims of the IDEA trial.

This service has been kindly supported by an unrestricted grant from Merck/MSD.

At the moment I’m involved with two projects in the context of GI cancer in the elderly and specifically colorectal cancer. The first project relates to the use of cetuximab in older patients with colorectal cancer, with metastatic colorectal cancer. We’ve been trying to get to collect the data from the most important phase III randomised trials where patients received, at least in one arm, cetuximab and the plan is to look at all the patients but compare the over- and under-70s in terms of efficacy and toxicity for the use of cetuximab and panitumumab. So we’re looking at anti-EGFR therapies in this setting. There is very little prospective data to consider so hopefully this will be very informative in our everyday practice, for our everyday practice.

The next project that I’m hoping to be involved in is to look at what happens to older patients in the adjuvant setting. So there is a large trial, this is a worldwide effort in fact, just under 15,000 patients, something called the IDEA trial. Patients have been randomised to receive three versus six months of chemotherapy which includes a fluoropyrimidine, either 5FU or capecitabine, in combination with oxaliplatin. The aim will be to look at patients over 70 who receive this kind of therapy and look at their outcomes. There have been some publications, mostly from the ACCENT database which suggest that using combination chemotherapy which includes oxaliplatin doesn’t necessarily add to what is achieved by 5-fluorouracil. So it will be interesting to look at this data on a large number of patients. At the moment we don’t know how many of these patients who were included in the study were over 70 but this is something that we need to look at.