657 - Adjuvant mfolfox6 in the treatment of elderly colon cancer patients

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anticancer Agents
Geriatric Oncology
Colon and Rectal Cancer
Therapy
Biological Therapy
Presenter Joana Godinho Bexiga
Authors J. Godinho Bexiga1, F. Carneiro2, D.S. Marques1, N. Sousa3, A. Raimundo4, M. Machado5, P. Ferreira1, C. Faustino3, M. Fragoso1
  • 1Medical Oncology, Portuguese Institute of Oncology of Oporto, 4200 - Oporto/PT
  • 2Medical Oncology, Portuguese Institute of Oncology of Oporto, Oporto/PT
  • 3Medical Oncology/ Hematology, Portuguese Institute of Oncology of Oporto, 4200 - Oporto/PT
  • 4Portuguese Institute of Oncology of Oporto, 4200 - Oporto/PT
  • 5Oncologia Ii, Portuguese Institute of Oncology of Oporto, 4200 - Oporto/PT

Abstract

Background

In Europe, more than 60% of new cancer cases and more than 70% of cancer deaths occur in elderly patients. Approximately 50% of colorectal cancer cases occur in patients ≥ 70 years. Despite this, elderly patients are under-represented in clinical trials. Adjuvant chemotherapy with Fluoropyrimidines and Oxaliplatin is the recommended treatment for stage III colon cancer. Our aim was to determine the effectiveness of mFOLFOX6 in the adjuvant treatment of elderly colon cancer patients.

Material and methods

Retrospective cohort study of colon cancer (CC) patients treated with adjuvant mFOLFOX6, in a Portuguese cancer centre, from September 2004 till November 2009. Elderly patients were defined as having ≥ 70 years old. Toxicity was evaluated using Common terminology criteria for adverse events (CTCAE), v 3. Comorbidity was assessed by Charlson's Index. The primary efficacy variable was disease-free survival (DFS). Secondary endpoints were cancer-specific survival (CSS), overall survival (OS) and toxicity grade ≥ 3. Hazard ratios and 95% confidence intervals were calculated with the use of the Cox proportional hazards model.

Results

In the study period, 277 patients were treated with adjuvant mFOLFOX6. Fifty three patients (19.1%) were ≥ 70 years and of these, 76.8% were male and 80% had stage III CC. Elderly patients were more likely to be male and have a higher comorbidity index than younger patients (p< 0.05). Patients older than 70 were more prone to grade ≥ 3 toxicity and a lower mean relative dose-intensity (Oxaliplatin: 66% vs 72%, p = 0.062; 5-Fluorouracil: 70% vs 76%, p = 0.01). With a median follow-up time of 45 months, elderly patients had 3 year DFS, CSS and OS of 82%, 92% and 84%, respectively. Survival wasn't significantly lower than that of patients aged < 70 (DFS: HR 0.612, p = 0.243; CSS: HR 0.533, p = 0.166; OS: HR 1.226, p = 0.674).

Conclusions

Adjuvant mFOLFOX6 is feasible in elderly patients and its benefit is similar to that of younger patients. Selection bias might explain the good results of this study and limit the external validity of our conclusions.

Disclosure

All authors have declared no conflicts of interest.