Real-world treatment and outcomes of metastatic colorectal cancer patients with a poor or very poor performance status

Abstract Introduction /Background: The management of metastatic colorectal cancer (mCRC) patients with a poor performance status (PS) continues to be a clinical dilemma, with the potential activity and safety of treating this population remaining poorly understood. Few of these patients are enrolled in clinical trials and poor PS is often multifactorial. Materials and Methods We analysed the Treatment of Recurrent and Advanced Colorectal Cancer registry to describe treatment practices and outcomes in poor (ECOG 2) and very poor PS (ECOG > 2) patients, to explore the relationship between age, tumour burden, comorbidities and PS, and to evaluate the benefit of systemic therapy. Standard descriptive statistical methods, Kaplan-Meier analysis and a multivariate Cox regression model were utilised. Results Of 2769 registry patients (diagnosed January 2009 – June 2018), 329 (12%) and 182 (7%) patients had a poor and very poor PS respectively. Good PS patients were more likely to receive systemic therapy than poor and very poor PS patients (85%, 55% and 21.5%, p Conclusion In routine clinical care, a substantial proportion of poor and very poor PS patients receive active treatment, which is often associated with meaningful clinical benefit.