Nikhil Prasad Fact checked by:Thailand Medical News Team Oct 13, 2025 2 hours, 8 minutes ago
Medical News: Older Patients May Not Benefit from Oxaliplatin in Colorectal Cancer
A large nationwide study from Korea has found that oxaliplatin-based chemotherapy significantly improves survival in stage III colorectal cancer only for patients aged 70 years or younger. In patients over 70, there was no survival benefit, and treatment was more likely to be stopped early due to side effects. For stage II colorectal cancer, oxaliplatin did not provide any added benefit regardless of patient age. This
Medical News report examines over 8,500 colorectal cancer patients treated between 2014 and 2016, comparing standard chemotherapy with oxaliplatin combinations to see whether an age threshold existed beyond which the extra drug stops helping.
Age 70 Cutoff for Chemotherapy Benefit in Colorectal Cancer
What the Study Did: Scope and Methods
The study, conducted by researchers led by Dr. Jun Woo Bong at Korea University, focused on health records of patients with stage II or III colorectal cancer who had surgery followed by chemotherapy. Two treatment groups were compared: those who received oxaliplatin-based combination chemo, and those given the standard non-oxaliplatin chemotherapy. The researchers used advanced statistical analysis to test different possible ages to see where survival benefit from oxaliplatin tapered off.
Key Findings: Survival Benefit and Age Thresholds
For stage III patients aged 70 or younger, adding oxaliplatin reduced mortality risk by 41 percent, increasing the five-year survival rate from about 78 percent to nearly 85 percent. For those older than 70, oxaliplatin offered no significant improvement in survival. Meanwhile, nearly 40 percent of older patients on oxaliplatin discontinued treatment early, largely due to toxicity. For stage II disease, there was no clear benefit at any age from including oxaliplatin.
Implications for Clinical Practice and Policy
Oncologists may begin using 70 years as a practical benchmark when deciding whether to add oxaliplatin to adjuvant chemotherapy for stage III colorectal cancer. In patients older than 70, the risk of side effects and treatment dropout may outweigh potential gains. For stage II disease, regardless of age, the evidence does not support the routine use of oxaliplatin. This could help reduce unnecessary exposure to toxicity and lower healthcare costs. Healthcare policy and guidelines may adjust to incorporate this threshold, emphasizing precision oncology that balances potential benefit with harm, especially in older populations.
Limitations and Areas Needing Further Study
The study was retrospective, relying on existing patient records rather than a randomized trial, which means there could be unmeasured confounders affecting results. Molecular marker data such as genetic mutations or biomarkers were lacking, making it difficult to determine whether certain subsets of older patients might still benefit from oxaliplatin. Other factors such as overall fitness, comorbidities, patient preferences, and quality of life were not fully explored
, yet these are especially relevant in older populations.
Conclusions
For patients with stage III colorectal cancer aged 70 or younger, oxaliplatin-based adjuvant chemotherapy clearly improves survival, lowering risk of death by about 41 percent and boosting 5-year survival from 78 percent to nearly 85 percent. For patients over 70, the survival benefit disappears, and nearly 40 percent of those treated with oxaliplatin discontinue therapy because of toxicity. In stage II disease, oxaliplatin does not provide added survival advantage at any age. These findings suggest that age 70 should be considered a critical cutoff in deciding whether to include oxaliplatin in postoperative chemo regimens, so that older patients are spared unnecessary side effects when benefit is unlikely.
The study findings were published in the peer reviewed journal: JAMA Network
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837317
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