# Efficacy and safety of postoperative adjuvant chemotherapy with oxaliplatin for elderly patients: results from the CCOG-1302 study

## TL;DR

This study examines the safety and effectiveness of oxaliplatin-based chemotherapy in elderly colorectal cancer patients.

## Contribution

The study provides evidence that oxaliplatin combination therapy is safe for elderly patients, with intermittent administration potentially reducing neuropathy risks.

## Key findings

- Elderly and non-elderly patients had similar rates of severe toxicities in both continuous and intermittent treatment arms.
- Intermittent treatment reduced residual peripheral sensory neuropathy in elderly patients over time.
- Three-year disease-free survival was not significantly different between elderly and non-elderly groups.

## Abstract

Postoperative adjuvant chemotherapy using oxaliplatin in addition to 5-FU-based anticancer agents has become the standard treatment for colorectal cancer, however, there is insufficient evidence regarding the efficacy and safety of oxaliplatin combination therapy in the elderly patients. In this study, retrospective analysis of the results from the CCOG-1302 study was performed to confirm them.

The patients in the CAPOX continuous (8 courses of CAPOX) and intermittent (2 courses of CAPOX + 4 courses of capecitabine + 2 courses of CAPOX) treatment arms in the CCOG-1302 study were divided into two groups, namely, the elderly (≥ 70) and non-elderly (< 70 years) groups. The adverse events, residual peripheral sensory neuropathy (PSN) and prognosis were analyzed.

The incidence of grade 3 or higher hematologic and non-hematologic toxicities in the continuous and intermittent treatment arm were not significantly different between the elderly and non-elderly groups. During the follow-up period, the percentages of grade I or higher PSN residuals were significantly higher among the elderly individuals in the continuous treatment arm at years 2, 3, 4, and 5. On the other hand, PSN decreased over time in the intermittent treatment arm as well as in the elderly and non-elderly patients. The 3-year DFS was not significantly different between the elderly and non-elderly groups in the continuous and intermittent treatment arms.

Oxaliplatin combination chemotherapy can be safely administered to elderly patients. In addition, intermittent administration may be more useful in elderly individuals for the prevention of PSN.

The online version contains supplementary material available at 10.1007/s10147-025-02738-w.