#South Korea #Seoul #Korea University #Colorectal Cancer #Oxaliplatin

Study Highlights

A groundbreaking study conducted by Korea University has found that colorectal cancer patients over the age of 70 gain no survival advantages from oxaliplatin-based chemotherapy, a commonly used treatment. Instead, the treatment leads to increased side effects and a higher likelihood of discontinuation among this demographic. Published online on August 6, 2025, in JAMA Network Open, the study analyzed a substantial database of over 8,500 patients treated for stage II and III colorectal cancer between 2014 and 2016.

Key Findings

The research indicated that for patients aged 70 or younger with stage III colorectal cancer, oxaliplatin reduced the risk of death significantly—by 41%. Five-year survival rates for this group improved from 78% to nearly 85%. However, in patients older than 70, the survival rates remained unchanged, raising concerns about the drug's toxicity. Almost 40% of older participants receiving oxaliplatin ceased treatment prematurely, primarily due to adverse side effects.

Interestingly, the use of oxaliplatin showed no benefit for stage II patients, regardless of age, casting doubt on its efficacy across different cancer stages.

“The key takeaway is that oxaliplatin is effective for younger patients with stage III colorectal cancer. However, for those above 70 years old, the negative aspects may outweigh any potential benefits,” stated Dr. Jun Woo Bong, the lead researcher from Korea University Guro Hospital.

Implications for Oncology

These findings have important implications for the oncology community. Dr. Hwamin Lee emphasized that this age threshold can help oncologists make informed, evidence-based decisions regarding chemotherapy regimens, ultimately preventing unnecessary adverse effects in older patients who are unlikely to benefit from such treatments.

The study's broader significance could reshape healthcare policy by steering away from ineffective treatments, thereby reducing healthcare costs and complications associated with unnecessary chemotherapy. Resources might then be redirected towards therapies that significantly enhance survival and quality of life for elderly patients.

Dr. Seogsong Jeong commented that the research lays the groundwork for future investigations into safer, more effective treatment alternatives for older cancer patients, highlighting the necessity of personalized care.

Future Directions

As cancer treatment increasingly shifts towards personalized medicine, the study underscores the importance of additional factors such as age and overall health, alongside tumor stages, in treatment planning. The potential for adopting an age threshold into clinical practice guidelines may represent a significant step toward precision oncology.

Despite the limitations, such as the retrospective nature of the study and absence of molecular marker data, the sheer scale of the research fortifies its conclusions, which are likely to influence both clinical guidelines and standard oncology practices. For younger stage III patients, oxaliplatin remains a potent treatment option, but for those over 70, there may be a pressing need to explore alternatives that prioritize both life expectancy and quality of life.

Conclusion

As new research continues to influence treatment paradigms, the need for a nuanced understanding of how age affects treatment efficacy becomes crucial. The findings from Korea University may not only change how colorectal cancer is treated but could also encourage a more individualized approach to cancer care, particularly for the aging population.

Reference: Older Age Threshold for Oxaliplatin Benefit in Stage II to III Colorectal Cancer. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.25660