First-Line Mono-Chemotherapy in Frail Elderly Patients with Metastatic Colorectal Cancer

Background: Unlike for fit elderly metastatic colorectal cancer (mCRC) patients, general approaches to initialtreatment for the frail older mCRC patients are not clear. Our aim was to evaluate the efficiency and safetyof first-line single-agent treatment in one such group. Materials and
Methods: We retrospectively evaluatedmCRC patients aged 70 or older with an Eastern Cooperative Oncology Group performance score of 2. Theyhad no prior treatment and underwent first-line single-agent capecitabine or other monotherapies until diseaseprogression or unacceptable toxicity.
Results: Thirty-six patients were included. Most (n:28, 77.8%) weretreated with capecitabine. One patient achieved a complete response and 5 patients had a partial response foran overall response rate of 16.6%. Twelve patients (33.3%) remained stable. Median progression free survivalwas 5 months (confidence interval (CI), %; 3.59-6.40) and median overall survival was 10 months (95 CI%;8.1-11.8). Grade 3-4 toxicity was found in 6 patients (16.6%). Febrile neutropenia was not observed and therewere no toxicity-associated deaths.
Conclusions: Capecitabine is a safe chemotherapeutic agent with moderateactivity for first-line treatment of older metastatic colorectal cancer patients with limited performance status.