Positive Outcomes for Cancer Patients in Poor Condition
But patients have higher risk of toxicity and death
THURSDAY, Mar. 5 (HealthDay News) -- Advanced colorectal cancer patients with poor performance status still derive benefit from chemotherapy, although with a higher risk of toxicity and death, according to study findings published online Mar. 2 in the Journal of Clinical Oncology.
Daniel J. Sargent, Ph.D., from the Mayo Clinic in Rochester, Minn., and colleagues retrospectively compared treatment efficacy based on Eastern Cooperative Oncology Group performance status in 6,286 clinical trial patients with metastatic colorectal cancer, where 509 patients had a poor performance status (performance status of 2). They note that patients with a poor performance status often comprise less than 10 percent of patients in clinical trials.
The investigators found that patients with a poor performance status benefitted just as much from modern chemotherapy regimens as patients with a better performance status (performance status of 0 or 1) in terms of progression-free survival, overall survival and response rate, although all three remained significantly lower for patients with poor performance status. However, treatment was associated with significantly more toxicity, including nausea of grade 3 or higher, vomiting and all-cause mortality at 60 days, the researchers report.
"On the basis of these results, oncologists can feel confident that treating patients who present with poor performance status as a result of their cancer with maximally effective chemotherapy is likely to provide patient benefit; however, regardless of regimen, these patients need to be managed attentively with supportive care," Sargent and colleagues conclude.
Several authors disclosed financial relationships with a variety of pharmaceutical companies.