JAMA Netw Open

What age is the tipping point for oxaliplatin benefit in colorectal cancer?

August 8, 2025

Study details: This population-based, retrospective cohort study analyzed data from 8,561 Korean patients with stage II–III colorectal cancer who underwent curative resection and received adjuvant chemotherapy between 2014 and 2016. Researchers compared overall survival between patients treated with oxaliplatin-based regimens and those receiving fluoropyrimidine-only therapy, systematically assessing age thresholds from 60 to 80 years.

Results: Oxaliplatin significantly improved survival in patients with stage III disease aged ≤70 years (adjusted hazard ratio [AHR] 0.59; 95% confidence interval [CI], 0.46–0.77), with a 5-year overall survival of 84.8% vs. 78.1% in the non-oxaliplatin group. No survival benefit was observed in patients >70 years or those with stage II disease. Additionally, oxaliplatin use in patients >70 years was associated with higher chemotherapy discontinuation rates.

Clinical impact: These findings suggest a clear age threshold for oxaliplatin benefit in stage III colorectal cancer, supporting its use in patients ≤70 years while prompting reevaluation of its role in older adults and those with stage II disease.

Source:

Bong JW, et al. (2025, August 6). JAMA Netw Open. Older Age Threshold for Oxaliplatin Benefit in Stage II to III Colorectal Cancer. https://pubmed.ncbi.nlm.nih.gov/40768144/