Tolerability of Raltitrexed ('Tomudex') in elderly patients with colorectal cancer |
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Authors: | Romiti Adriana Tonini Giuseppe Santini Daniele Di Seri Marisa Masciangelo Raffaele Mezi Silvia Verì Attilio Santuari Lucia Vincenzi Bruno Brescia Antonio Marchei Paolo Frati Luigi Tomao Silverio |
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Affiliation: | National Cancer Institute of Genoa, Section of Rome, Department of Experimental Medicine and Pathology, La Sapienza University of Rome, Rome, Italy. adriana.romi@tin.it |
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Abstract: | PURPOSE: Colorectal cancer (CRC) is one of the major health problems of the Western world and the proportion of elderly patients with CRC is growing. Raltitrexed ('Tomudex'), a specific thymidylate synthase inhibitor, has shown efficacy and manageable toxicity in elderly CRC patients. In this retrospective study, the tolerability of raltitrexed in patients with CRC was examined in relation to age. PATIENTS AND METHODS: Toxicity parameters, graded according to World Health Organization criteria, were assessed in two patient groups: < 70 and > or = 70 years old. In total, 56% (50 out of 90) of patients treated with raltitrexed (3 mg/m2 as a 15-minute intravenous infusion every 3 weeks) were aged > 70 years (M:F 28:22; Eastern Cooperative Oncology Group performance status 0-1:2 38:12). RESULTS: Overall, 437 cycles of chemotherapy were administered and grade 3-4 toxicity was reported in < 10% of patients. There were no clinically significant differences between the two age groups, apart from grade 3-4 asthenia, which was reported by 6% and 0% of patients aged > or = 70 and < 70 years, respectively. This was in spite of a significantly lower calculated mean creatinine clearance in patients aged > or = 70 years compared with those patients < 70 years of age. CONCLUSION: The raltitrexed toxicity profile does not appear to be significantly influenced by age; however caution is recommended in the management of elderly patients, particularly in the presence of impaired renal function. |
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