Pooled analysis of oxaliplatin-based adjuvant chemotherapy for stage III colon cancer in older patients

A number of studies suggest that older patients may have reduced or no benefit from the addition of oxaliplatin to fluoropyrimidines as adjuvant chemotherapy for stage III colon cancer. Pooled analysis of 12 clinical studies included 17,909 patients receiving CAPOX for stage III colon cancer, with 4,340 (24%) being aged 70 years or older. The group of older patients had higher rated of early treatment discontinuation. Rated of grade ≥ 3 adverse events were similar between the older and younger group, except for diarrhea (14.2% versus 11.2%; p=0.01) and neutropenia (12.1% versus 9.6%; p=0.04). In multivariable analysis, time to recurrence was not significantly different between the two age groups, but disease-free survival, overall survival, survival after recurrence, and cancer-specific survival were significantly shorter in the group of older patients. The authors conclude that in patients aged ≥ 70 years with stage III colon cancer fit enough to be enrolled in clinical trials, oxaliplatin-based adjuvant chemotherapy was well tolerated and led to similar time to recurrence compared with younger patients, suggesting similar efficacy.