- Volume 7
- Issue 1 Publication Date: January 2008
Oxaliplatin in Combination with 5-Fluorouracil/Leucovorin or Capecitabine in Elderly Patients with Metastatic Colorectal Cancer
Hendrik-Tobias Arkenau, Ullrich Graeven, Stephan Kubicka, Axel Grothey, Christina Englisch-Fritz, Albrecht Kretzschmar, Richard Greil, Werner Freier, Thomas Seufferlein, Axel Hinke, Hans-Joachim Schmoll, Wolff Schmiegel, Rainer Porschen, on Behalf of the AIO Colorectal Study Group
Background:� We evaluated the outcome of 140 patients aged� ≥ 70 years of age who received first-line treatment for metastatic colorectal cancer within the German phase III trial of FUFOX� (5-fluorouracil/leucovorin/oxaliplatin)� versus CAPOX� (capecitabine/oxaliplatin).� Patients and Methods:� One hundred forty� (30%)� elderly patients of 476 total patients were identified, and 138 patients received the CAPOX or FUFOX treatment.� Results:� Overall, treatment was well tolerated, and grade 3/4 toxicities were similar in both groups, with more gastrointestinal side effects in the elderly group but less neurosensory side effects. The response rate� (RR)� was comparable between both cohorts� (49% in elderly patients vs. 52% in patients aged� < 70 years). Median progression-free survival� (PFS)� was 7.7 months for patients aged� ≥ 70 years and 7.5 months for patients aged� < 70 years� (hazard ratio [HR], 1.07; 95% CI, 0.86-1.34). With regard to the chemotherapy regimen, there was no inferiority between FUFOX and CAPOX in patients aged ≥ 70 years� (7.9 months vs. 7.6 months). The median overall survival� (OS)� between FUFOX and CAPOX was comparable in patients aged� ≥ 70 years� (14.4 months vs. 14.2 months). However, when compared with patients aged� < 70 years, the median OS was significantly shorter� (18.8 months vs. 14.4 months;� P� = 0.013; HR, 1.37; 95% CI, 1.07-1.76). This was consistent with our multivariate analysis, which revealed that age� ≥ 70 years was a negative factor for OS.� Conclusion:� Oxaliplatin combined with 5-FU/leucovorin or capecitabine was generally well tolerated in elderly patients. Elderly patients had similar PFS and overall RRs compared with the population aged� < 70 years, but the OS was shorter.