Oxaliplapin and capecitabine (XELOX) based chemotherapy in the treatment of metastatic colorectal cancer: The right choice in elderly patients

Massimiliano Berretta, Giuseppe Aprile, Guglielmo Nasti, Martina Urbani, Alessandra Bearz, Stefania Lutrino, Luisa Foltran, Laura Ferrari, Renato Talamini, Francesco Fiorica, Arben Lleshi, Vincenzo Canzonieri, Chiara Lestuzzi, Eugenio Borsatti, Rossella Fisichella, Umberto Tirelli

Research output: Contribution to journalArticlepeer-review


Purpose: Elderly patients with metastatic colorectal cancer (mCRC) differ from the general population and are underrepresented in clinical trials. We, retrospectively, analyzed the safety and efficacy of XELOX regimen in the treatment of elderly patients affected by mCRC. Patients and methods: One-hundred-eleven consecutive patients, aged 70 years or older, were enrolled in the study. Results: All patients were evaluated for safety and efficacy (male/female, 63/48). Median age was 75 years (range 71-85 years). Median Eastern Cooperative Oncology Group Performance Status was 0 (range 0-2). Metastatic sites distribution is as follows: liver (44.1%), lung (13.5%), liver plus lung (12.6%) and other (29.7%). A total of 584 cycles were administered (median 6 cycles/patient, range 2-10). Median follow-up time was 14.5 months (range 1-41 months). In an intent-to-treat analysis, objective responses and stable disease were recorded in 41 (40.4%) and 29 (26.6%) patients, respectively. The median response duration was 5.9 months (range 0.5-28.8). The median progression free-survival (PFS) was 7.5 months (range 1-26 months). The median overall survival (OS) was 15 months (range 1-64 months). The grade 3 toxicities were: neutropenia (8.1%), diarrhea and neurotoxicity (5.4% respectively). Most adverse events were mild to moderate; the most common was acute sensory neuropathy (57.6%). Conclusion: XELOX is a highly effective first-line treatment for mCRC elderly patients. Response rates, PFS and OS are similar to those observed with fluorouracil/leucovorin/oxaliplatin combinations. XELOX is a convenient regimen, likely to be preferred by both patient and healthcare providers.

Original languageEnglish
Pages (from-to)1344-1353
Number of pages10
JournalAnti-Cancer Agents in Medicinal Chemistry
Issue number9
Publication statusPublished - 2013


  • Chemotherapy
  • Colorectal cancer
  • Elderly patients
  • Oxaliplatin

ASJC Scopus subject areas

  • Cancer Research
  • Molecular Medicine
  • Pharmacology
  • Medicine(all)


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