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Poster session 16

572P - Tolerance of adjuvant chemotherapy in older patients after resection of stage III colon adenocarcinoma from PRODIGE 34 – FFCD 1402 - ADAGE randomized phase III trial

Date

14 Sep 2024

Session

Poster session 16

Topics

Cancer in Older Adults

Tumour Site

Colon and Rectal Cancer

Presenters

Thomas Aparicio

Citation

Annals of Oncology (2024) 35 (suppl_2): S428-S481. 10.1016/annonc/annonc1588

Authors

T. Aparicio1, P. Etienne2, O. Bouche3, E. Barbier4, S. hiret5, H. Ammarguellat6, R. Desgrippes7, J. Martin8, V. Guerin Meyer9, V. Le Brun-Ly10, M. Ben Abdelghani11, C. Falandry12, J. Turpin13, Y. Rinaldi14, J. Desrame15, R. Darrius16, A. Villing17, C.I. Furtos18, C. Lepage19, L. Mineur20

Author affiliations

  • 1 Gastroenterology And Digestive Oncology Department, Hopital Saint Louis AP-HP, 75010 - Paris/FR
  • 2 Oncology, Hôpital Privé des Côtes d'Armor, 22190 - Plérin/FR
  • 3 Gastroenterology And Digestive Oncology, Hopital Robert Debré - CHU de Reims, 51100 - Reims/FR
  • 4 Biostatistics, Fédération Francophone de Cancérologie Digestive, 21079 - Dijon/FR
  • 5 Medical Oncology, ICO Institut de Cancerologie de l'Ouest René Gauducheau, 44805 - Saint-Herblain/FR
  • 6 Radiotherapy Department, Centre Hospitalier Simone Veil Beauvais, 60021 - Beauvais/FR
  • 7 Ille Et Vilaine, Saint Malo hospital, 35403 - Saint Malo/FR
  • 8 Department, Centre de Radiologie Chenieux, 87000 - Limoges/FR
  • 9 Oncology Department, Centre Paul Papin, 49055 - Angers/FR
  • 10 Oncology Department, CHU Limoges - Hopital Dupuytren, 87042 - Limoges/FR
  • 11 Oncology Department, ICANS - Institut de Cancérologie Strasbourg Europe, 67200 - Strasbourg/FR
  • 12 Geriatrics Department, Lyon Sud Hospital Center, 69495 - Pierre Benite/FR
  • 13 Gastroenterology Department, CH Abbeville, 80142 - Abbeville/FR
  • 14 Hepatogastroenterology Department, Hopital Européen Marseille, 13003 - Marseille/FR
  • 15 Gastroenterology Department, Hôpital privé Jean Mermoz, 69373 - Lyon/FR
  • 16 Gastroenterology Department, Hopitaux Civils de Colmar, 68024 - Colmar/FR
  • 17 Medical Oncology Department, CH Auxerre, 89011 - Auxerre/FR
  • 18 Martinique, CHU - Centre Hospitalier Universitaire de Martinique, 97261 - Fort-de-France, Cedex/MQ
  • 19 Hepato Gastroenterology And Digestive Oncology Dept., CHU Dijon, 21079 - Dijon/FR
  • 20 Vaucluse, Institut du Cancer Avignon-Provence - Sainte-Catherine, 84918 - Avignon/FR

Resources

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Abstract 572P

Background

Oxaliplatin (Ox) + fluoropyrimidine (F) chemotherapy is the standard of adjuvant chemotherapy after resection of colon cancer but the tolerance of oxaliplatin is a concern in older patients (pts).

Methods

The ADAGE trial had compared 6 months adjuvant chemotherapy of Ox + F versus F alone after resection of a stage III colon cancer. We report the tolerance at 6 months after the beginning of the treatment, the dose reduction and the early discontinuation of chemotherapy. Efficacy results are expected in 2026.

Results

The analysis was performed on 757 pts (378 in Ox and 379 in F). The median age was 77 years and 56.9% pts were male. Capecitabine was the fluoropyrimidine given in 16.9% of pts in F and 11% in Ox. Table: 572P

Fluoropyrimidine arm Oxaliplatin arm
Median treatment duration in months 5.09 5.29
Mean dose intensity received- 5FU bolus- 5FU continuous- Capecitabine- Oxaliplatin 81.2%89.8%72.2%NA 59.9%84.3%72.7%63.0%
Early discontinuation of chemotherapy 13.9% 18.5%
Grade 3-5 toxicity: Total- Neurotoxicity- Diarrhea- Vomiting- Neutropenia- Anemia- Thrombopenia- Hepatic disorder- Asthenia 27.9%0.5%4.9%0.5%3%0%0% 1.1%3.3% 58.4%20.9%8.6%1.3%22.5%0.5% 2.1% 7.2%5.9%

In multivariate analysis the factors significantly associate with a grade 3-5 toxicity were the arm (Ox vs F): OR=3.86 [95%CI: 2.80-5.32], p80): OR=Ref vs 1.64 [95%CI: 1.13-2.39] vs 1.43 [95%CI: 0.94-2.17], p=0.031 and sex (male vs female): OR=0.72 [95%CI: 0.52-0.99], p=0.042.

Conclusions

Adjuvant chemotherapy with oxaliplatine is feasible in older patients but cause an increase of severe toxicity and a decrease of dose intensity that may modify efficacy. Patients over 75 and women are more at risk for toxicity.

Clinical trial identification

NCT02355379.

Editorial acknowledgement

Legal entity responsible for the study

Fédération Francophone de Cancérologie Digestive.

Funding

Fédération Francophone de Cancérologie Digestive.

Disclosure

T. Aparicio: Financial Interests, Personal, Invited Speaker, 2022: Servier; Financial Interests, Personal, Invited Speaker, 3 Conferences: Pierre Fabre; Financial Interests, Personal, Advisory Board, 2 Board in 2022 and 2023: BMS; Financial Interests, Personal, Invited Speaker, 1 conference: MSD; Non-Financial Interests, Leadership Role, 2021-2024: Fédération Francophone de Cancérologie Digestive. O. Bouche: Financial Interests, Personal, Advisory Board: Amgen, Merck, Apmonia Therapeutics, Deciphera, Astellas, Takeda; Financial Interests, Personal, Invited Speaker: Servier, Pierre Fabre, Bayer. R. Desgrippes: Financial Interests, Personal, Advisory Board: Servier; Financial Interests, Institutional, Invited Speaker: Merck; Non-Financial Interests, Member of Board of Directors: Fédération Francophone de Cancérologie Digestive. M. Ben Abdelghani: Financial Interests, Personal, Invited Speaker: Incyte, Servier, Pierre Fabre; Financial Interests, Personal, Advisory Board: Merck, BMS, Bayer; Financial Interests, Institutional, Advisory Board: Deciphera. C. Falandry: Financial Interests, Personal, Invited Speaker: Leo Pharma, Pfizer, MSD Oncology, AstraZeneca, Janssen Oncology, Novartis, Astellas Pharma, BMS, GSK, Lilly, Viatris, Biogaran, Seagen; Financial Interests, Personal, Advisory Board: Teva, Baxter, Eisai, Chugai Pharma, GSK, Clovis Oncology; Financial Interests, Institutional, Coordinating PI: Chugai Pharma, Pfizer, Pierre Fabre, Astellas Pharma; Financial Interests, Institutional, Local PI: Pfizer; Non-Financial Interests, Personal, Other, Congress Participation: Janssen Oncology, Pierre Fabre, AstraZeneca, Leo Pharma; Non-Financial Interests, Member, International Society of Geriatric Oncology: SIOG; Non-Financial Interests, Member, French-speaking society of geriatric oncology: SOFOG; Non-Financial Interests, Member, European geriatric medicine society: EUGMS; Non-Financial Interests, Member, French society of geriatrics and gerontology: SFGG. C. Lepage: Financial Interests, Personal, Advisory Board: AAA; Financial Interests, Personal, Invited Speaker: Amgen, Pierre Fabre, IPSEN. All other authors have declared no conflicts of interest.

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