Effect of Diabetes on Outcomes in Patients With Incurable/Unresectable and Advanced/Recurrent Colorectal Cancer Receiving mFOLFOX6.

Background/aim: The high mortality rate associated with colon cancer in patients with diabetes is well-established; however, the underlying mechanisms have not been fully elucidated. Here, we investigated the efficacy of modified FOLFOX6 (mFOLFOX6) therapy, which is frequently used in colon cancer treatment, in patients with and without comorbid diabetes.
Patients and Methods: The participants in this retrospective cohort study received mFOLFOX6 therapy as a first-line treatment for incurable/ unresectable and advanced/recurrent colon cancer. We compared patient background characteristics; number of mFOLFOX6 courses; total dose of each drug; reasons for dose reduction, deferment, or discontinuation; and survival time.
Results: Data of six patients with diabetes and 26 without diabetes were assessed. There was no significant difference in background characteristics between the patient groups, with the exception of blood glucose levels. There was no significant difference in the planned number of mFOLFOX6 courses between the groups; however, the total number of completed courses was significantly lower in patients with diabetes than in those without diabetes. Discontinuation rates due to adverse events were similar between the groups; however, discontinuation due to progressive disease or death was significantly higher in patients with diabetes than in those without diabetes. No significant differences were observed in the total dose of each anticancer drug or survival time between the groups.
Conclusion: mFOLFOX6 may not have sufficient therapeutic effects in patients with diabetes. Therefore, in patients with concurrent diabetes and colon cancer, alternative therapeutic options for cancer treatment should be considered.
Competing Interests: Hisateru Yasui received honoraria from Yakult Honsha.
(©2025 The Author(s). Published by the International Institute of Anticancer Research.)