Biweekly capecitabine + oxaliplatin (CAPOX) slashes cytopenias while matching 3‑yr DFS in high‑risk stage II/III colorectal cancer

CAPOX couples oral fluoropyrimidine (capecitabine) with platinum DNA‑crosslinking agent oxaliplatin; the standard adjuvant schedule is every 3 weeks. In the Chinese phase II RCT NCT03564912, 160 post‑surgery high‑risk stage II/III CRC patients were randomized to modified biweekly CAPOX (oxaliplatin 85 mg/m² d1, capecitabine 1 g/m² BID d1‑10) or conventional triweekly CAPOX (oxaliplatin 130 mg/m² d1, capecitabine 1 g/m² BID d1‑14). All‑grade thrombocytopenia fell to 33% vs 49% (p = 0.02) and neutropenia to 36% vs 51% (p = 0.04). Three‑year DFS was numerically higher with the biweekly regimen (85.1% vs 80.4%; HR 0.78, 95% CI 0.38‑1.63, p = 0.51), and therapy completion improved (7.5% vs 15% discontinuations). These DFS figures meet—and slightly exceed—the 75.9% 3‑yr DFS reported for triweekly CAPOX in the large IDEA consortium, despite lower cumulative oxaliplatin dosing.