Age 70 identified as cutoff for chemotherapy benefit in colorectal cancer

Medical Xpress / Korea University College of Medicine / JAMA Network Open ^ | Sept. 18, 2025 | Jun Woo Bong et al

[ConservativeMind]

Colorectal cancer remains a leading cause of cancer death, with incidence rising among older adults. One of the most pressing clinical questions has been whether elderly patients should receive oxaliplatin, a standard component of adjuvant chemotherapy that is known to cause serious side effects.

To address this, Dr. Jun Woo Bong conducted a large-scale population study.

The team examined health records from more than 8,500 patients with stage II or III colorectal cancer who underwent surgery followed by chemotherapy between 2014 and 2016. Patients were divided into two groups: those treated with oxaliplatin-based combinations, and those given standard chemotherapy alone. Using advanced statistical methods, the researchers systematically tested whether an age threshold existed at which oxaliplatin stopped providing survival benefits.

The results were decisive. In stage III patients aged 70 or younger, oxaliplatin reduced the risk of death by 41%, boosting five-year survival from 78% to nearly 85%. But in those older than 70, oxaliplatin did not improve survival and was linked to higher rates of treatment discontinuation. In fact, almost 40% of older patients receiving oxaliplatin stopped chemotherapy early, often due to toxicity. For stage II patients of any age, oxaliplatin showed no added survival benefit.

"The most important point is that oxaliplatin improves survival only in patients with stage III colorectal cancer who are aged 70 years or younger. Beyond 70, the benefit disappears, and oxaliplatin is associated with higher discontinuation rates due to toxicity," said Dr. Bong.

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TOPICS: Health/Medicine
KEYWORDS:

[ConservativeMind]

Chemo for advanced colon cancer takes too much out of people at age 70, and beyond.

[ConservativeMind]

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[Getready]

Title is way the h*ll misleading. The study only examined Oxiplatin use. Not any other chemotherapy alone, or chemotherapy with other therapies(immunotherapy, etc,)
Very bad title. Someone over 70 might read the title and think a diagnosis of colorectal cancer means no hope.

[John Milner]

I would think it would be a case by case decision. If the person is otherwise strong and healthy it would be worth considering.

[HighSierra5]

Well, I’ve got 25 days before I’m SOL. I beat liver cancer with immunotherapy so.......

[FlyingEagle]

I turn 70 at the end of this month. Am stage 3 survivor of this cancer from 18 years ago, had this very chemo plus some other stuff. The chemo almost killed me.

[Getready]

Exactly ..I don’t think the study took that variable into its analysis. I don’t remember the study saying how advanced the tumors were...maybe if caught early the Oxiplatin. might be effective if patient is above 70 and otherwise healthy.

[higgmeister]

More death panels letting septuagenarians and older go to the proverbial elephants graveyard to die and ‘decrease the surplus population’.

[Deaf Smith]

Ivermectin has been used to treat colon cancer since 2018.

See: NIH.

[Ignatz]

Chemo is, in practice, poisoning the entire body in hopes that the cancer dies before the patient does.

It’s sad but understandable that some choose to quit chemo.

[Myrddin]

My Whipple for ampullary cancer in June 2024 occurred at age 67. It also came with complications including abdominal abscess (staphylococcus), lots of blood and fluid in my abdomen and MRSA pneumonia. Chemo is avoided in the presence of infections as it compromises the immune system. Upon surgical pathology report, I was PT3a, PN0, R0 Stage IIb. Absent the infections I might have been eligible for post surgical chemo. By the time the infections were definitively cleared, it was November 25, 2024. I finally saw the medical oncologist and was told that chemo has no demonstrated efficacy beyond 12 weeks after surgery. I was 20 weeks past, so no chemo. Age 68.

I have a friend who is my age now...69. He has been fighting pancreatic cancer for 3 years. The chemo is too much now. He is Stage 4. He has decided to just live life until he can't. Quality over quantity. We call ourselves the "Whipple Bros". A little gallows humor to lighten the mood.

[NonValueAdded]

Lovely

[grame]

My hubby had his chemo at 73, two years ago. He has been cancer free even though they couldn’t get all of the involved lymph nodes out. They took part of his colon. His next checkup is tomorrow. But I will to some degree say yes, it depletes you. He had a part-time job before covid/cancer struck. (He was hospitalized with severe Covid and the discovered his cancer because of his bloodwork results.) He has not been able to return because of the fatigue issues. But I also know carrying the cancer around might have been the thing that caused him to live defeated. The Lord wasn’t ready for him yet. But I’m might have to read a bit more on this and what impact we can have on future decisions.

[skr]

It sounds like a way to ration Medicare services to me.