SAFETY AND EFFICACY OF OXALIPLATIN-BASED CHEMO-THERAPY IN THE FIRST LINE TREATMENT OF ELDERLY PATIENTS AFFECTED BY METASTATIC COLORECTAL CANCER

Introduction: Elderly patients constitute a subpopulation with special clinical features that differ from those of the general population and are under-represented in clinical trials. Materials and methods: We analyzed the toxicity and efficacy of an oxaliplatin-based chemotherapy (FOLFOX2, FOLFOX4 and XELOX) in the treatment of elderly patients affected by metastatic (m) colorectal cancer (CRC). One hundred and sixty-seven consecutive patients (FOLFOX2 20 patients; FOLFOX4 36 patients; XELOX 111 patients) aged 65 to 85 years (median age 75 years), 101 males and 66 females, with mCRC and measurable disease, were analyzed. The primary site of metastases was the liver (44% of patients). The majority of patients had a median performance status (PS) (ECOG) of 0 (range 0-2). Results: The overall response rates according to the treatment schedules were: FOLFOX2 55%, FOLFOX4 44,4%, and XELOX 40.4%. The median progression-free survival (PFS) was about 7.3 months in all treatments and the median overall survival (OS) rates were: FOLFOX 2 21.8 months, FOLFOX4 16 months and XELOX 16 months. The main hematological and extra-hematological toxicities (grade 3 or 4) were neutropenia (14.4%), and neurological toxicity or diarrhea (15%). No toxic death occurred. Conclusions: Oxaliplatin-based chemotherapy maintain its efficacy, and safety in elderly patients with mCRC and good PS. The different results in terms of PFS and OS, according to the treatment performed, could be dependent on the different number of patients enrolled in each study. This regimen should be considered in the treatment of this particular setting of patients.