Oxaliplatin, fluorouracil, and leucovorin are commonly used to treat advanced and resected colorectal cancer.
Dr Daniel Sargent and colleagues from Minnesota compared the safety and efficacy of oxaliplatin plus fluorouracil/leucovorin in young patients.
The team conducted a retrospective analysis of the 3,724 colorectal cancer patients from 4 clinical trials of the adjuvant, first-, and second-line settings.
The combination treatment was administered bimonthly in patients age younger than and at least 70 years.
End points included grade 3 adverse events, response rate, progression or relapse-free survival, and dose-intensity.
|Grade 3 toxicity, and 60-day mortality was not associated with older age|
|Journal of Clinical Oncology|
The research team also assessed overall survival in the studies with mature survival data.
The team found that grade 3 hematologic toxicity and thrombocytopenia were significantly higher in older patients.
Older age was not associated with increased rates of severe neurologic adverse events, diarrhea, nausea/vomiting, or infection.
The team noted that the overall incidence of grade 3 toxicity, or 60-day mortality was not associated with older age.
The benefit of the combination treatment versus control did not differ by age for response rate, progression or recurrence free-survival, or overall survival.
The researchers observed that dose-intensity did not differ by age at cycles 1, 3, 6, or 12.
Dr Sargent's team concludes, “Oxaliplatin plus fluorouracil/leucovorin maintains its efficacy and safety ratio in selected elderly patients with colorectal cancer.”
“Its judicious use should be considered without regard to patient age, although scant data are available among patients older than 80 years.”