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.
Resources from the same session
577P - Results of the phase Ib study of NC410 combined with pembrolizumab in MSS/MSI-L colorectal cancer patients
Presenter: Eric Christenson
Session: Poster session 16
579P - Intratumoral fusobacterium as prognostic factor in early stage colorectal cancer: Results of the FUSOMAP study
Presenter: Paolo Nuciforo
Session: Poster session 16
581P - mRNA profiling as a biomarker of prognosis and response to first-line treatment in metastatic colorectal cancer: Discovery and validation of a gene expression signature in three randomized trials
Presenter: Marco Germani
Session: Poster session 16
582P - Prognostic role of macrophage infiltration and monocyte-to-lymphocyte ratio in stage III colon cancer: The MIRROR study
Presenter: debora basile
Session: Poster session 16
583P - COMPReS study: Multiomic profiling reveals organ-specific differences in metastases and identifies novel predictive biomarkers in relapsed localized colon cancer
Presenter: Blanca García-Mico
Session: Poster session 16
584P - Genomic and transcriptomic characterization of peritoneal, lung and liver metastases of colorectal carcinoma reveals site-specific differences
Presenter: Nerma Crnovrsanin
Session: Poster session 16
585P - Prospective validation of the metastatic colon cancer score (mCCS) in patients with RAS wild-type metastatic colorectal cancer treated with first-line panitumumab plus FOLFIRI/FOLFOX: Final results of the non-interventional study VALIDATE
Presenter: Norbert Marschner
Session: Poster session 16
586P - Clinical and molecular characteristics of colorectal adenosquamous carcinoma: A multicenter retrospective study
Presenter: Jun Huang
Session: Poster session 16