Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 

3-month chemo may be sufficient for most patients with colon cancer

Elvira Manzano
12 Jun 2017

Three vs 6 months of adjuvant oxaliplatin-based chemotherapy may be sufficient for colon cancer with low risk of recurrence and has the advantage of fewer side effects, according to the IDEA* trial which pooled data from six phase III trials.

“This is extremely important work that will affect the lives of many of my patients,” commented ASCO expert Dr Nancy Baxter from St Michael’s Hospital in Toronto, Ontario, Canada. “Today, up to 60 percent of my patients with stage III colon cancer will be able to stop after 3 months of therapy and get on with their lives and have a lower risk of permanent problems, such as numbness of their hands and feet.”

Researchers compared 3 months vs 6 months of adjuvant oxaliplatin-based therapy in patients with node-positive stage III colon cancer who underwent surgery. The median duration of follow-up was 39 months. [ASCO 2017, abstract LBA1)

“With 12,834 patients from 12 countries included in the study, this is the largest collaboration of its kind in gastrointestinal oncology,” said principal investigator Dr Axel Grothey from the Mayo Clinic Cancer Center in Rochester, Minnesota, US.

Dr Axel Grothey_02

For all patients, the rate of disease-free survival (DFS) at 3 years appeared comparable between 3 and 6 months of chemotherapy (74.6 percent vs 75.5 percent, hazard ratio [HR], 1.07). The type of chemotherapy regimen used affected the difference in 3-year DFS between courses (75.9 percent vs 74.8 percent; HR, 0.95 with CAPOX [capecitabine/oxaliplatin] and 73.6 percent vs 76 percent; HR, 1.16 with FOLFOX [leucovorin, fluorouracil, oxaliplatin]). However, the difference was relatively small in both regimens.


In a subset of patients with lower risk of cancer recurrence (1-3 nodal involvement but has not spread to the bowel wall; 60 percent of patients in the study), the difference in DFS was very small (83.1 percent vs 83.3 percent for 3 and 6 months of chemotherapy). “Three months of chemotherapy will likely become the new standard of care in this group of patients with lower recurrence risk,” said Grothey.

When it comes to treatment-related serious adverse effects, nerve damage (Grade 2 or higher) was consistently higher in those receiving 6 months vs 3 months of chemotherapy (48 percent vs 17 percent with CAPOX; 45 percent vs 15 percent with FOLFOX).

Aside from nerve damage, longer chemotherapy translates to more diarrhoea and fatigue, more doctor appointments and blood draws, and time away from work, said Grothey.

“Patients with higher-risk colon cancer, however, should discuss these results with their doctor to see if a shorter course of therapy would be right for them, taking into account their preference, age, and ability to tolerate chemotherapy.”

The IDEA trial was funded by the US National Institutes of Health and other non-commercial entities in participating countries. “Who is interested in shortening the duration of therapy from a commercial perspective? These trials can only be conducted with a publicly funded clinical trial system,” said Grothey.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacy - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute.