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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