Certain Chemotherapy May Increase Toxicity for Women With Colon Cancer

Female patients with colon cancer who receive adjuvant fluoropyrimidine-based chemotherapy treatment are at greater risk of toxicity, research reveals.

During an adjuvant chemotherapy study focusing on patients with colon cancer, researchers found sex to be an important factor in patients’ drug responses and toxicity levels.

“The objective of our study was to compare incidence and severity of major toxicities of fluoropyrimidine- (5FU or capecitabine) based adjuvant chemotherapy, with or without oxaliplatin, between male and female patients after curative surgery for colon cancer,” the authors reported.

Data was pulled from 34,640 patients within 27 randomized trials—from the Adjuvant Colon Cancer End Points (ACCENT) database—and a multigroup repository, including international, independent patient information.

“Data was compared against logistic regression models, stratified by study and treatment arm within each type of adjuvant chemotherapy (5FU, FOLFOX, capecitabine, CAPOX, and FOLFIRI),” the authors explained.  

Toxicities were analyzed by grade III, IV, and grade I-IV—following the National Cancer Institute Common Terminology Criteria [NCI-CTC]—including vomiting, nausea, stomatitis, diarrhea, leukopenia, neutropenia, thrombocytopenia, neuropathy, and anemia.

“Women with colon cancer receiving adjuvant fluoropyrimidine-based chemotherapy are at increased risk of toxicity. Given the known sex differences in fluoropyrimidine pharmacokinetics, sex-specific dosing of fluoropyrimidines warrants further investigation,” the authors concluded.

--Angelique Platas

Reference:

Wagner A, Grothey A, Andre T, Dixon J, Wolmark N, Haller D, et al. Sex and adverse events of adjuvant chemotherapy in colon cancer: an analysis of 34640 patients in the Accent database. JNCI. 2021; 113(4):400–407. https://doi.org/10.1093/jnci/djaa124