According to the findings from a subanalysis of the XELOXA trial, XELOX (capecitabine + oxaliplatin) is associated with improved disease-free survival (DFS) over bolus 5-FU/LV regimens in stage III colon cancer, regardless of age. This research was presented at the ASCO 2010 Gastrointestinal Cancers Symposium (ASCO-GI; see the link below to access the abstract).

The authors note that a recent analysis of the ACCENT database, presented at ASCO 2009, concluded that newer adjuvant regimens are not associated with significant efficacy benefits versus 5-FU/LV in patients aged 70 years and above.  They therefore conducted a post-hoc analysis of the XELOXA trial (NO16968), which compared adjuvant treatment with XELOX versus 5-FU/LV in patients with lymph-node positive colon cancer (n=1,886), to see if age affected results. 

The original study found that XELOX was associated with improved disease free survival (DFS; primary endpoint) at 3 years compared with 5-FU/LV (70.9% vs. 66.5%).  In this subgroup analysis, the authors found the following:

• In patients aged ≥70 years (n=409), DFS was 66% in the XELOX arm and 60% in the 5-FU/LV arm (HR 0.87; 95% CI 0.63 to 1.18).  In patients aged ≥65 years (n=744), the respective results were 68% and 62% (HR 0.81; 95% CI 0.64 to 1.03).
 
• After a median follow-up of 57 months, the three-year DFS in patients <70 years was 72% with XELOX and 69% with the control regimen (HR 0.79; 95% CI 0.66 to 0.94).

Neither result was statistically significant as the 95% CI of the hazard ratios crossed 1; when questioned about this the lead investigator commented that the principal objective of the study was to examine the data for evidence of trends. 
Overall survival data were not sufficiently mature to perform definitive analyses.